Issue: November 2011
November 01, 2011
1 min read

Appropriate ICD interventions found in half of ARVD/C patients

Bhonsale A. J Am Coll Cardiol. 2011;58:1485-1496.

Issue: November 2011
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About one-half of patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy after placement of an implantable cardioverter defibrillator for primary prevention experience appropriate interventions, new data suggest.

The study included patients from the Johns Hopkins registry with definite or probable arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C), defined by the presence of major and minor diagnostic criteria according to the 2010 revised Task Force Criteria, who underwent ICD implantation for primary prevention. Researchers obtained detailed phenotypic, genotype and ICD event information and assigned appropriate ICD therapies based on patients’ intracardiac electrograms.

There were 84 ARVD/C patients who received an ICD for primary prevention of sudden cardiac death, and 48% of patients received appropriate ICD therapy during a mean of 4.7 ± 3.4 years. According to researchers, proband status (HR=6.4; 95% CI, 2.3-18.2), the presence of nonsustained ventricular tachycardia (HR=3.8; 95% CI, 1.9-7.6), inducibility at electrophysiologic study (HR=3.1; 95% CI, 1.4-6.9) and Holter premature ventricular complex count of more than 1,000/24 hours (HR=3.1; 95% CI, 1.1-8.3) were predictors of appropriate ICD therapy; and nonsustained ventricular tachycardia (HR=10.54; 95% CI, 2.40-46.18) and inducibility at electrophysiologic study (HR=4.5; 95% CI, 1.37-14.96) were predictors of appropriate ICD interventions on multivariable analysis.

During long-term follow-up, researchers saw device-related complications in only 24% of patients. Researchers found a cumulative survival free of appropriate ICD therapy of 73% at 1-year follow-up, 64% at 2 years, 42% at 5 years and 37% at 10 years.

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