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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
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Incidence and Predictors of Appropriate Implantable Cardioverter-Defibrillator Therapy in Light Chain Cardiac

Thibaut Moulin1, Amira Zaroui2, Khaled Ramoul1

  • 1Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Henri Mondor University Hospital, Créteil, France.

JACC. Clinical Electrophysiology
|February 27, 2026
PubMed

Insights

Sudden cardiac death is common in light chain cardiac amyloidosis (AL CA). Prophylactic ICDs in AL CA patients show high appropriate therapy rates, with impaired LV global longitudinal strain predicting risk.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Amyloidosis Research

Background:

  • Sudden cardiac death is a significant cause of mortality in light chain cardiac amyloidosis (AL CA).
  • Limited data exist on the effectiveness of implantable cardioverter defibrillators (ICDs) in AL CA patients.
  • Understanding ICD therapy outcomes is crucial for managing this high-risk population.

Purpose of the Study:

  • To determine the incidence of appropriate ICD therapies in AL CA patients.
  • To identify predictors of appropriate ICD therapies in this cohort.
  • To evaluate the role of ICDs in primary prevention for AL CA.

Main Methods:

  • Retrospective study of AL CA patients who received ICDs between November 2014 and May 2024.
  • Primary endpoint: first appropriate ICD therapy (shock or antitachycardia pacing).
  • Analysis of factors associated with appropriate ICD therapies, including left ventricular (LV) global longitudinal strain.

Main Results:

  • 150 AL CA patients with primary prevention ICDs were analyzed.
  • 18.0% of patients received at least one appropriate ICD therapy over a median follow-up of 16.8 months.
  • Impaired LV global longitudinal strain (cutoff -9.5%) was independently associated with a significantly higher risk of appropriate ICD therapy (aSHR: 5.33).

Conclusions:

  • AL CA patients receiving prophylactic ICDs experience frequent appropriate therapies.
  • LV global longitudinal strain may aid in risk stratification for ventricular arrhythmias in AL CA.
  • Further research is needed to clarify the impact of ICDs on overall survival in AL CA.
Abstract

Keywords:
cardiac amyloidosisdefibrillatorglobal longitudinal strainprimary preventionsudden cardiac deathventricular arrhythmia

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