[Characteristics and causes of death in 283 patients with implanted defibrillators].
The implantable automatic defibrillator has proved its superiority over pharmacological treatments for preventing mortality by serious ventricular arrhythmia. We studied the cause of death in a population of 283 consecutive patients implanted between February 1988 and December 2000 (age at implantation: 58 +/- 14.7 years; extremes: 15-78 years, 45 females, ejection fraction: 0.39 +/- 0.15) and followed up over a median of 25 months (extremes = 1 day-163 months).


RESULTS
At the end of follow up, 55 patients had died (average age: 62.7 +/- 12.6 years, extremes: 15-79 years, 7 females). All except 2 had a cardiopathy: ischaemic cardiopathy (n = 38, 36 IDDM), dilated cardiomyopathy (n = 14), arrhythmogenic dysplasia of the right ventricle (n = 1). The median interval between implantation and death was 35 months (extremes = 1 day-137 months). The causes of death were the following: cardiac insufficiency (n = 24), refractory arrhythmias (n = 13), other cardiac causes (n = 8), extra-cardiac pathologies (n = 10). The deceased patients had presented an average of 86.6 +/- 23.4 ventricular arrhythmias (extremes = 0-1309) but 18 of them (33%) did not present any during follow up.


CONCLUSIONS
Cardiac insufficiency is the prime cause of death in refractory arrhythmias; on patient in 4 dies from ventricular arrhythmia, despite the defibrillator and one deceased patient in 3 had no arrhythmia during follow up.
Blangy
H
H
Departement des maladies cardio-vasculaires, service du Pr Aliot, CHU de Nancy Brabois, allée du Morvan, 54511 Vandoeuvre-lés-Nancy
Sadoul
N
N
de Chillou
C
C
Dodinot
B
B
Magnin-Poull
I
I
Brembilla-Perrot
B
B
Aliot
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000401:mortality* / Q000628:therapy*; D002423:Cause of Death; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies