Do patients with an implantable defibrillator live longer?

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Implantation of automatic cardioverter-defibrillators is reported to abort sudden cardiac death due to malignant tachyarrhythmias.
• Sudden cardiac death (SCD) remains a significant concern in patients with tachyarrhythmias.

Purpose of the Study:

• To evaluate the efficacy of implantable cardioverter-defibrillator (ICD) therapy in preventing sudden and arrhythmia-related deaths.
• To assess the impact of ICD therapy on overall patient survival.

Main Methods:

• A cohort of 107 patients underwent screening for third-generation ICD implantation with endocardial leads between 1989 and 1992.
• Patient data, including mean age (57 years) and ejection fraction (40%), were analyzed.
• Sudden death, arrhythmia-related death, and cardiac death rates were compared with the incidence of ventricular tachyarrhythmias, assuming untreated arrhythmias would be fatal.

Main Results:

• Surgical mortality was 2.7% overall and 1% for the 99 patients receiving endocardial leads.
• During a 12-month follow-up, actuarial survival rates free of events were 100% for sudden death, 97% for arrhythmia-related death, and 95% for cardiac death.
• Survival free of fast ventricular tachycardia was 83% at 6 months, decreasing to 69% at 18 months. Survival free of any ventricular tachyarrhythmia was significantly lower.

Conclusions:

• Implantable cardioverter-defibrillator therapy with endocardial leads yields excellent patient outcomes.
• This therapeutic approach is considered potentially lifesaving for individuals susceptible to life-threatening tachyarrhythmias.