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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Implantable cardioverter defibrillators for primary prevention in cardiomyopathies
Vineetha Kanneganti1, Ajay Bahl2, Manoj Kumar Rohit2
1Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Implantable cardioverter defibrillators (ICDs) provided appropriate therapy in 32% of young Indian patients with cardiomyopathy. However, inappropriate shocks and complications were also frequent, highlighting the need for careful patient selection and monitoring.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Device Technology
Background:
- Implantable cardioverter defibrillators (ICDs) are utilized for primary prevention of sudden cardiac death (SCD) in young individuals.
- This study focuses on the real-world outcomes of ICDs in the Indian population, specifically analyzing therapy efficacy and safety.
Purpose of the Study:
- To evaluate the incidence of appropriate ICD therapies in patients with cardiomyopathy receiving ICDs for primary prevention.
- To assess the rates of inappropriate therapies and complications associated with ICD implantation in this cohort.
- To identify predictors of appropriate ICD therapy through correlation and regression analyses.
Main Methods:
- Retrospective analysis of patients with cardiomyopathy who underwent ICD implantation for primary prevention.
- Review of ICD interrogations and stored electrograms to analyze therapy delivery and underlying arrhythmias.
- Statistical analysis including correlation and regression to determine predictors of appropriate therapy.
Main Results:
- A total of 50 patients were followed for a mean of 4.4 years (220.2 patient-years).
- Appropriate ICD therapy was delivered to 32% of patients (29.5 events per 100 patient-years).
- Inappropriate therapy occurred in 14% of patients (19.9 events per 100 patient-years), and complications in 16% (3.6 events per 100 patient-years).
Conclusions:
- Appropriate ICD therapy was observed in 32% of patients with cardiomyopathy receiving ICDs for primary prevention over a mean follow-up of 4.4 years.
- Inappropriate therapies (14%) and complications (16%) were common, underscoring the importance of careful patient selection and device management.
Background:
Implantable cardioverter defibrillators (ICD) are often used as primary prevention strategy for sudden cardiac death (SCD) in young individuals. This study analyzed appropriate therapies, complications and inappropriate shocks in the real-world Indian population.
Methods:
All patients in the cardiomyopathy cohort under follow up who had ICD implanted as a primary prevention strategy were studied. The objective was to assess the incidence of appropriate ICD therapies, inappropriate therapies and complications. ICD was interrogated and stored electrograms analyzed. Underlying arrhythmia or conditions resulting in appropriate or inappropriate ICD therapy were studied. Correlation and regression studies was done to assess for the predictors of appropriate therapy.
Results:
Fifty patients were followed up for a mean follow-up duration of 4.4 ± 3.1 years with total follow up of 220.2 patient years. Appropriate ICD therapy was delivered in 16 out of 50 (32%) patients, with 65 appropriate therapies (median 2 per patient, range: 0-20). Inappropriate therapy delivered in 7 of the 50 (14%) patients, with 44 inappropriate therapies (median 5 per patient, range: 0-20). Complications occurred in 8 of the 50 (16%) patients. Overall, the rate of appropriate therapy was 29.5 per 100 patient years, that of inappropriate therapy was 19.9 per 100 patient years and the rate of complications was 3.6 per 100 patient years.
Conclusions:
When implanted for primary prevention in patients with cardiomyopathies over a mean period of 4.4 ± 3.1 years, appropriate ICD therapy was delivered in 32% patients. However, inappropriate therapy (14% patients) and complications (16% patients) were also common.
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