Related Experiment Video
Updated: May 5, 2026
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 Defibrillator in Nonischemic Versus Ischemic Cardiomyopathy: Real-World Primary Prevention
Fankun Ma1, Yang Gao1, Haibo Yu1
1Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, People's Republic of China.
Insights
Implantable cardioverter defibrillators (ICDs) show similar effectiveness for preventing sudden cardiac death (SCD) in both ischemic and nonischemic cardiomyopathy patients. This study found no significant outcome differences between these groups after ICD implantation.
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure
Background:
- Implantable cardioverter defibrillators (ICDs) are established for primary prevention of sudden cardiac death (SCD) in ischemic cardiomyopathy (ICM).
- Evidence for ICDs in nonischemic cardiomyopathy (NICM) for primary SCD prevention is less clear, prompting further investigation.
- This study aimed to compare prognostic outcomes between ICM and NICM patients receiving ICDs for primary SCD prevention.
Purpose of the Study:
- To evaluate prognostic differences in sudden cardiac death (SCD) and mortality between patients with ischemic cardiomyopathy (ICM) and nonischemic cardiomyopathy (NICM) after implantable cardioverter defibrillator (ICD) implantation.
- To determine if etiology of heart failure impacts the effectiveness of ICDs in primary SCD prevention.
- To compare rates of malignant ventricular arrhythmias, all-cause mortality, cardiovascular mortality, and appropriate ICD therapy between ICM and NICM groups.
Main Methods:
- Retrospective enrollment of 342 patients who underwent ICD implantation for primary SCD prevention between January 2017 and May 2023.
- Patients were categorized into ischemic cardiomyopathy (ICM) and nonischemic cardiomyopathy (NICM) groups based on heart failure etiology.
- Kaplan-Meier survival analysis and COX-adjusted models were used to compare primary (SCD/malignant ventricular arrhythmias) and secondary (all-cause mortality) endpoints between the groups.
Main Results:
- The cohort comprised 213 (62.3%) NICM patients and 129 (37.7%) ICM patients.
- At a median follow-up of 23 months, 51 patients (14.9%) experienced primary endpoint events.
- Kaplan-Meier analysis revealed no statistically significant differences between NICM and ICM groups for primary endpoint events (p=0.413), all-cause death (p=0.208), cardiovascular mortality (p=0.218), or appropriate ICD therapy (p=0.250). COX models confirmed these findings.
Conclusions:
- Primary prevention of sudden cardiac death (SCD) using implantable cardioverter defibrillators (ICDs) demonstrates similar efficacy in both ischemic cardiomyopathy (ICM) and nonischemic cardiomyopathy (NICM) patients in real-world settings.
- Outcomes including SCD, malignant ventricular arrhythmias, all-cause mortality, cardiovascular mortality, and appropriate ICD therapy are comparable between ICM and NICM groups.
- The findings support the use of ICDs for primary SCD prevention regardless of cardiomyopathy etiology.
Background:
The evidence in the primary prevention of sudden cardiac death (SCD) by using implantable cardioverter defibrillators (ICD) in patients with ischemic cardiomyopathy (ICM) is well-established but remains controversial for those with nonischemic cardiomyopathy (NICM). This study evaluates whether prognostic differences exist between ICM and NICM patients after ICD implantation.
Methods:
Patients initially undergoing ICD implantation as primary SCD prevention were retrospectively enrolled from January 2017 to May 2023. Malignant ventricular arrhythmic and/or SCD were set as the primary endpoint, whereas all-cause mortality was the secondary endpoint. Patients were grouped by heart failure etiology (ICM vs. NICM) and then by primary endpoint events occurrence. Outcomes analyses were performed between the NICM and ICM patients.
Results:
The final cohort had 342 patients, 213 (62.3%) with NICM and 129 (37.7%) with ICM. At a median follow-up of 23.0 (10.7, 33.2) months, 51 patients (14.9%) encountered primary endpoint events. No statistically significant disparities in primary endpoint events (log rank p = 0.413), all-cause death (log rank p = 0.208), cardiovascular mortality (log rank p = 0.218), or appropriate ICD therapy (log rank p = 0.250) between the two groups were indicated by Kaplan-Meier survival analysis. Moreover, the COX-adjusted models further demonstrated the absence of any significant differences between the two groups.
Conclusion:
In real-world settings, primary prevention of SCD with ICD implantation yields similar outcomes for ICM and NICM patients, including probabilities of SCD and/or malignant ventricular arrhythmias, all-cause mortality, appropriate ICD therapy, and cardiovascular mortality.
More Related Videos
12:45Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
10:17Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
Related Concept Videos
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease IV: Preventive Measures
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:29Cardiomyopathy V: Interprofessional Care