Incidence and characteristics of appropriate and inappropriate therapies in recipients of ICD implanted for primary prevention of sudden cardiac death.
BACKGROUND
We evaluated the number of appropriate and inappropriate therapies for ventricular tachyarrhythmias and trigger mechanisms in 55 MADIT II (MII)-like (group 1) and 86 SCD-HeFT-like (group 2) patients.


RESULTS
We analyzed 399 appropriate episodes in 31 patients with implantable cardioverter defibrillators (ICD) implanted according to the MII trial indications, and 502 appropriate episodes in 47 patients matching the SCD-HeFT trial criteria (mean follow-up in both groups = 33 +/- 19 months). In group 1, 39 treated episodes were inappropriate (9% of all episodes), while in group 2, 76 episodes were treated inappropriately (15% of all episodes). At least one episode of inappropriate ICD therapy was recorded in 18% of patients in group 1 (n = 10) and in 22% of patients in group 2 (n = 19).


CONCLUSIONS
Our study supports the implantation of ICD as primary prevention in patients who are at risk of sudden cardiac death, although the proportion of inappropriate ICD interventions remains high.
Kreuz
Jens
J
Department of Medicine-Cardiology, University of Bonn, Bonn, Germany. jekreuz@yahoo.de
Balta
Osman
O
Liliegren
Nora
N
Mellert
Fritz
F
Esmailzadeh
Bahman
B
Nickenig
Georg
G
Schwab
Jörg Otto
JO
D000368:Aged; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000628:therapy*