Outcome of cardioverter-defibrillator implant in patients with arrhythmogenic right ventricular cardiomyopathy.
The aim of the present study was to investigate outcomes of implantable cardioverter-defibrillator (ICD) treatment in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). We reviewed baseline/follow-up data of 15 consecutive ARVC patients (mean age 55 +/- 15 years) and 30 randomly drawn patients with coronary artery disease (CAD) (mean age 60 +/- 10 years) with matching durations of follow-up (all implanted with ICDs for primary/secondary prevention of sudden death). At implant, appropriate placement of the RV lead was more difficult in ARVC patients. During follow-up (median 41 months), appropriate interventions for any ventricular tachyarrhythmias occurred in 8 (53%) ARVC patients and 17 (57%) CAD patients, but the occurrence of high rate (>240 beats/min) ventricular tachyarrhythmias was higher in ARVC patients. Inappropriate ICD interventions occurred in 5 (33%) ARVC patients and 10 (33%) CAD patients. Lead-related adverse events requiring surgical revision occurred in 7 (47%) ARVC patients as compared with 4 (13%) CAD patients (P = 0.0004). While ICD implantation is highly effective for prevention of sudden death in ARVC, it does carry elevated burdens of long-term lead-related adverse events. These findings underline the need of careful follow-up in ARVC aimed at early recognition of complications that can impair ICD function.
Boriani
Giuseppe
G
Istituto di Cardiologia, Università di Bologna, Policlinico S. Orsola-Malpighi, via Massarenti 9, 40138, Bologna, Italy. giuseppe.boriani@unibo.it
Artale
Paolo
P
Biffi
Mauro
M
Martignani
Cristian
C
Frabetti
Lorenzo
L
Valzania
Cinzia
C
Diemberger
Igor
I
Ziacchi
Matteo
M
Bertini
Matteo
M
Rapezzi
Claudio
C
Parlapiano
Mario
M
Branzi
Angelo
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000628:therapy*; D003131:Combined Modality Therapy; D017147:Defibrillators, Implantable / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents