Long-Term Prognosis in Recipients of Implantable Cardioverter-Defibrillators for Secondary Preventions in Taiwan - A Multicenter Registry Study.
BACKGROUND
The use of an implantable cardioverter-defibrillator (ICD) has a proven capacity to prevent sudden cardiac death (SCD), and can also improve survival duration in well-selected patients. The goal of the present study was to investigate the long-term prognosis and predictors of mortalities among ICD recipients in Taiwan.


METHODS
From 1998 to 2009, 238 consecutive patients who experienced SCDs or life-threatening ventricular tachyarrhythmias without correctable causes and received ICD implantations in 3 medical centers (Taipei, Taichung and Kaohsiung Veterans General Hospital) were enrolled in this study. The clinical endpoint was defined as the occurrence of all-cause mortality during the follow-up.


RESULTS
The mean age of the patients was 63.0 ± 15.3 years, and 76.5% of them were male. Ischemic cardiomyopathy was the leading cause for the ICD implantations (39.1%). During the mean follow-up duration of 36.8 ± 29.8 months, there were 48 patients (20.2%) who died. Patients with structural heart diseases had a higher mortality rate than those without such diseases. Additionally, old age, low left ventricular ejection fraction (LVEF) and a history of diabetes mellitus (DM) were significant predictors of mortality. The optimal cutoff values for age (70 years) and LVEF (40%) in predicting mortality were further identified using the receiver operating characteristic curves.


CONCLUSIONS
Based on the ICD registry from 3 medical centers in Taiwan, the annual mortality rate was around 6.6% and was higher in those patients with structural heart diseases. We observed that old age, low LVEF and a history of DM were significant predictors of mortality.


BACKGROUND
Implantable cardioverter-defibrillator; Mortality; Predictor; Taiwan.
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; ; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan;
Tze-Fan
TF
Chao
Division of Cardiology, Taipei Medical University - Shuang Ho Hospital, Taipei, Taiwan;
Chih-Hung
CH
Lai
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; ; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; ; Division of Cardiology, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan;
Ta-Chuan
TC
Tuan
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; ; Cardiovascular Center, Taichung Veterans General Hospital, Taichung;, Taiwan ; School of Medicine, Chung-Shan Medical University, Taichung, Taiwan;
Tsu-Juey
TJ
Wu
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; ; Cardiovascular Center, Taichung Veterans General Hospital, Taichung;, Taiwan ; School of Medicine, Chung-Shan Medical University, Taichung, Taiwan;
Jin-Long
JL
Huang
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; ; Division of Cardiology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;
Chuen-Wang
CW
Chiou
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; ; Division of Cardiology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;
Hsiang-Chiang
HC
Hsiao
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; ; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan;
Yenn-Jiang
YJ
Lin
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; ; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan;
Jo-Nan
JN
Liao
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; ; Division of Cardiology, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan.
Chi-Woon
CW
Kong
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; ; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan;
Shih-Ann
SA
Chen