[The importance of the underlying disease for outcome of patients with implanted automatic defibrillators]

It is unclear whether the outcome of patients with implanted cardioverter defibrillator (ICD) is influenced by the underlying etiology or not. Therefore, we studied the follow-up of 271 patients who underwent ICD implantation for life-threatening ventricular tachyarrhythmias. Coronary artery disease was present in 203 patients (75%) (G1), dilated cardiomyopathy in 36 patients (18%) (G2), while 32 patients (12%) (G3) had an "arrhythmogenic" ventricle (dysplasia, valvular disease, idiopathic arrhythmias). Mean left ventricular ejection fraction was 30 +/- 11% in G1, 33 +/- 13% in G2 and 48 +/- 13% in G3. Perioperatively, 12/271 patients (4%) died. During the mean follow-up of 21 +/- 17 (< 1 to 99) months, 52/259 patients (20%) died: 31% (11/36 patients) in G2, 19% (36/193 patients) in G1 and 17% (5/39 patients) in G3. There was a low incidence of sudden death (SD) (4%, 2% per year) without significant differences between G1 (3%), G2 (8%) and G3 (3%). In addition, no significant differences were observed in cardiac mortality (CD) between G1 (10%), G2 (14%) and G3 (3%) (p = n.s.). ICD discharges occurred in 188 patients (69%); ICD discharges occurred in G1 in 138 patients (68%), in G2 in 27 patients (75%) and in G3 in 23 patients (72%). The mean incidence of ICD discharges per patient was 16 +/- 10 shocks in G1, 24 +/- 8 shocks in G2 and 18 +/- 8 shocks in G3. After ICD implant, complications occurred in 67 patients (23%). Our data show that the ICD is highly effective in preventing sudden death independent on the underlying etiology.(ABSTRACT TRUNCATED AT 250 WORDS)