title: Syncope in Primary Prevention Implantable Cardioverter Defibrillator Patients.
abstract: BACKGROUND
  Syncope is a common clinical condition spanning from benign to life-threatening diseases. There is sparse information on the outcomes of syncopal patients who received an implantable cardiac defibrillator (lCD) for primary prevention of sudden cardiac death (SCD).
  
  
  OBJECTIVE
  To assess the outcomes and prognosis of patients who underwent implantable cardiac defibrillator (ICD) implantation for primary prevention of SCD and compare them to patients who presented with or without prior syncope.
  
  
  METHODS
  We compared the medical records of 75 patients who underwent ICD implantation for primary prevention of SCD and history of syncope to those of a similar group of 80 patients without prior syncope. We assessed the episodes of ventricular tachycardia (VT), ventricular fibrillation (VF), shock, anti-tachycardia pacing (ATP) and mortality in each group during follow-up.
  
  
  RESULTS
  Mean follow-up was 893 days (810-976, 95% CI) (no difference between groups). There was no significant difference in gender or age. Patients with prior syncope had a higher ejection fraction rate (35.5 ? 12.6 vs. 31.4 8.76, P = 0.02), experienced more episodes of VT (21.3% vs. 3.8%, P = 0.001) and VF (8% vs. 0%, P = 0.01), and received more electric shocks (18.7% vs. 3.8%, P = 0.004) and ATP (17.3% vs. 6.2%, P = 0.031). There were no differences in inappropriate shocks (6.7% vs. 5%, P = 0.74), cardiovascular mortality (cumulative 5 year estimate 29.9% vs. 32.2%, P = 0.97) and any death (cumulative 5 year estimate 38.1% vs. 48.9%, P = 0.18).
  
  
  CONCLUSIONS
  Patients presenting with syncope before ICD implantation seemed to have more episodes of VT/VF and shock or ATP. No differences in mortality were observed.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Goldenberg
authors.forename: Tamir
authors.initials: T
authors.lastname: Bental
authors.forename: Udi
authors.initials: U
authors.lastname: Kadmon
authors.forename: Ronit
authors.initials: R
authors.lastname: Zabarsky
authors.forename: Jairo
authors.initials: J
authors.lastname: Kusnick
authors.forename: Alon
authors.initials: A
authors.lastname: Barsheshet
authors.forename: Gregory
authors.initials: G
authors.lastname: Golovchiner
authors.forename: Boris
authors.initials: B
authors.lastname: Strasberg
mesh_terms: D000368:Aged; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D017147:Defibrillators, Implantable / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D059035:Perioperative Period; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011322:Primary Prevention / Q000379:methods; D011379:Prognosis; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013575:Syncope / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000401:mortality