title: Clinical follow-up of patients with implantable cardioverter-defibrillator.
abstract: OBJECTIVE
  To report appropriate (AT) and inappropriate (IT) ICD therapies in patients with ischemic and nonischemic heart disease, as well as early and late procedure-related complications.
  
  
  METHODS
  One hundred and fifty-five patients (119 male and 36 female), mean age 47 years (21-88), who underwent ICD implantation between 1994 and March 2003 were analyzed. Patients were divided into the following groups: Group I--Post-AMI patients (n = 80); Group II--Patients with nonischemic heart disease and LV ejection fraction < 40% (n = 45), Chagas disease (n = 18), idiopathic dilated cardiomyopathy (n= 12), hypertensive disease (n = 8), hypertrophic cardiomyopathy (n = 4) and valvular heart disease (n = 3); Group III--Patients with arrhythmogenic right ventricular dysplasia (n = 13); and Group IV--Patients with channelopathies: Brugada Syndrome (n = 8) and idiopathic ventricular arrhythmias (n = 9). All patients underwent electrophysiological study (EPS) with induction of sustained ventricular arrhythmia ICD implantation.
  
  
  RESULTS
  During the 26-month mean follow up, a high rate of appropriate ICD therapies (antitachycardia pacing and/or shock) was observed (46%) in the four groups, with no statistically significant difference. The four groups did not differ in either overall (8.4%) or arrhythmic mortality (1.3%). There was no correlation between appropriate ICD therapies and initial clinical presentation or inducible ventricular arrhythmia at EPS, and a 4% incidence of early and late procedure-related complications was found.
  
  
  CONCLUSIONS
  The high incidence of appropriate ICD therapy and low rate of sudden death in the patients studied suggest that ICD is a valuable strategy in the management of ischemic and nonischemic patients previously selected by means of EPS.
authors.affiliation: Hospital Universitário Clementino Fraga Filho, Clínica São Vicente, Rio de Janeiro, RJ, Brazil smartelo@openlink.com.br
authors.forename: Silvia Martelo Souza
authors.initials: SM
authors.lastname: da Fonseca
authors.forename: Luiz Gustavo
authors.initials: LG
authors.lastname: Belo
authors.forename: Hécio
authors.initials: H
authors.lastname: Carvalho
authors.forename: Nilson
authors.initials: N
authors.lastname: Araújo
authors.forename: Cláudio
authors.initials: C
authors.lastname: Munhoz
authors.forename: Leonardo
authors.initials: L
authors.lastname: Siqueira
authors.forename: Washington
authors.initials: W
authors.lastname: Maciel
authors.forename: Eduardo
authors.initials: E
authors.lastname: Andréa
authors.forename: Jacob
authors.initials: J
authors.lastname: Atié
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D017147:Defibrillators, Implantable / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000150:complications / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology*