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Long-Term Outcome of ICD Therapy in Patients With Noncompaction Cardiomyopathy Compared With DCM and HCM

Emrah Kaya1, Martijn Otten2, Dominic A M J Theuns3

  • 1Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Cardiology, St. Antonius Hospital Nieuwegein, the Netherlands.

JACC. Clinical Electrophysiology
|May 4, 2023
PubMed

Insights

Long-term outcomes for implantable cardioverter-defibrillators (ICDs) in noncompaction cardiomyopathy (NCCM) patients are similar to dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) patients. ICD interventions and survival rates do not significantly differ between these cardiomyopathy groups.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Implantable cardioverter-defibrillators (ICDs) are crucial for primary and secondary prevention in various cardiomyopathies.
  • Long-term outcome data for ICD therapy in noncompaction cardiomyopathy (NCCM) patients remain limited.
  • Understanding ICD efficacy in NCCM is vital for patient management.

Purpose of the Study:

  • To compare the long-term outcomes of ICD therapy in patients with NCCM versus those with dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM).
  • To analyze ICD interventions and survival rates across different cardiomyopathy types.

Main Methods:

  • Prospective data analysis from a single-center ICD registry (January 2005 - January 2018).
  • Comparison of 68 NCCM patients with 458 DCM and 158 HCM patients.
  • Evaluation of ICD interventions and patient survival over a median follow-up of 5 years.

Main Results:

  • No significant differences in appropriate or inappropriate ICD interventions were observed between NCCM, DCM, and HCM groups.
  • Nonsustained ventricular tachycardia during Holter monitoring was a significant risk factor for appropriate ICD therapy in NCCM patients (HR: 5.29).
  • Univariable analysis suggested better long-term survival in NCCM, but this was not confirmed in multivariable analysis.

Conclusions:

  • ICD intervention rates (appropriate and inappropriate) in NCCM patients are comparable to those in DCM and HCM patients at 5-year follow-up.
  • Multivariable analysis revealed no significant differences in survival between the cardiomyopathy groups.
  • These findings support the use of ICDs in NCCM patients with similar considerations as in DCM and HCM.
Abstract

Keywords:
dilated cardiomyopathyhypertrophic cardiomyopathyimplantable cardioverter defibrillatornoncompaction cardiomyopathyprognosis

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