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Mortality in patients with implanted automatic defibrillators.

M Mirowski, P R Reid, R A Winkle

    Annals of Internal Medicine
    |May 1, 1983
    PubMed
    Summary
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    Automatic implantable defibrillators significantly reduce mortality in high-risk cardiac arrest survivors. These devices correct life-threatening ventricular tachyarrhythmias, improving 1-year survival rates by an estimated 52%.

    Area of Science:

    • Cardiology
    • Biomedical Engineering

    Background:

    • Sudden cardiac arrest survivors face high mortality risks.
    • Malignant tachyarrhythmias are a primary cause of sudden cardiac death.
    • Automatic implantable defibrillators (AIDs) offer a potential therapeutic intervention.

    Purpose of the Study:

    • To evaluate the efficacy of AIDs in preventing mortality in patients post-cardiac arrest.
    • To assess the device's ability to manage tachyarrhythmic events.
    • To determine the impact of AIDs on 1-year survival rates.

    Main Methods:

    • Implantation of AIDs in 52 patients who survived cardiac arrest.
    • Cardiovascular surgery was performed as indicated.
    • Follow-up averaged 14.4 months, with a maximum of 3 years.

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    Main Results:

    • AIDs identified and reverted 82 spontaneous and 81 of 99 induced tachyarrhythmias in-hospital.
    • 62 automatic resuscitations occurred in 17 patients outside the hospital.
    • 1-year mortality was 8.5% (sudden death), a 52% reduction from the expected 48%.

    Conclusions:

    • AIDs effectively identify and correct lethal ventricular tachyarrhythmias.
    • AID implantation leads to a substantial increase in 1-year survival for selected high-risk patients.
    • AIDs represent a significant advancement in managing patients at risk for sudden cardiac death.