Publikation

Prophylactic implantable cardioverter defibrillator therapy in dilated cardiomyopathy: impact of left ventricular function

Wissenschaftlicher Artikel/Review - 22.03.2006

Bereiche
PubMed
DOI

Zitation
Schaer B, Ammann P, Sticherling C, Zellweger M, Cron T, Osswald S. Prophylactic implantable cardioverter defibrillator therapy in dilated cardiomyopathy: impact of left ventricular function. International journal of cardiology 2006; 108:26-30.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
International journal of cardiology 2006; 108
Veröffentlichungsdatum
22.03.2006
ISSN (Druck)
0167-5273
Seiten
26-30
Kurzbeschreibung/Zielsetzung

BACKGROUND: The value of an implantable cardioverter defibrillator (ICD) for primary prevention in dilated cardiomyopathy (DCM) is unclear, as randomized trials could not show a survival benefit compared to drug therapy. It has not been investigated if patients with a very poor left ventricular function (LVEF) could profit from an ICD. METHODS: Consecutive patients with DCM who received an ICD between December 1996 and November 2003 were included in this analysis. Patients were divided in group A (secondary prevention) and group B (primary prevention). Both groups were stratified in subgroups with left ventricular ejection fraction (LVEF) below and above 20%. RESULTS: Fifty eight patients were included (male 50, age 56.4+/-12.7 years). Follow-up was 34+/-19 months. There was no difference regarding death (18% vs. 11%), but significant differences (p value <0.05) regarding any adverse events (55% vs. 22%), any ICD intervention (48% vs. 17%) and ICD interventions for life-threatening arrhythmias (27% vs. 0%) between group A and B. LVEF was not predictive for events in group A, whereas in group B only patients with a LVEF <20% had events (p value 0.02). Over time there was an increase of the LVEF of more than 15% determined by echocardiography in 36% of patients, significantly more often in group B. CONCLUSIONS: Indication for primary prevention with an ICD in DCM should be made with caution. Larger studies are needed to determine if patients with LVEF of <20% might benefit from an ICD.