title: Temporal trends and long term follow-up of implantable cardioverter defibrillator therapy for secondary prevention: A 15-year single-centre experience.
abstract: BACKGROUND
  The aim of this study was to determine overall and aetiology-related incidence of secondary prevention ICD implantation over the last 15years in Canton Ticino and to assess clinical outcome according to time period of implantation.
  
  
  RESULTS
  Consecutive patients treated by implantation of an ICD for secondary prevention from 2000 to 2015 were included in the current study and compared between 5-year cohorts (2000/2004; 2005/2009; 2010/2015). Yearly implantation rate, changing in clinical presentation over years and events during follow-up were evaluated. One-hundred fifty six patients were included. ICD implantation rate increased from 2.1 in 2000-2005 to 5.1 in 2010-2015, respectively (p 0.001). There was an increase in the proportion of non-ischaemic patients and of ventricular tachycardia (VT) as presenting rhythm. No differences in appropriate ICD interventions were observed according to aetiology, presenting arrhythmia or type of device. Reverse remodelling was observed more often in non-ischaemic patients, without any influence on the occurrence of appropriate interventions. Previous myocardial infarction (MI), atrial fibrillation (AF), NYHA class 2-3 and left ventricular ejection fraction (LVEF)<35% were predictors of appropriate therapies during follow-up.
  
  
  CONCLUSIONS
  Rate of implants for secondary prevention indication has almost doubled during the last 15years. Importantly, there has been a progressive increase of non-ischaemic patients receiving an ICD, and of VT as presenting rhythm. Patients had an overall good survival and a relatively low incidence of appropriate therapies. Improvement of ejection fraction did not correlate with risk reduction of ventricular arrhythmias.
authors.affiliation: Cardiocentro Ticino, Lugano, Switzerland. Electronic address: marialuce.caputo@cardiocentro.org.
authors.forename: Maria Luce
authors.initials: ML
authors.lastname: Caputo
authors.affiliation: Cardiocentro Ticino, Lugano, Switzerland.
authors.forename: François
authors.initials: F
authors.lastname: Regoli
authors.affiliation: Cardiocentro Ticino, Lugano, Switzerland.
authors.forename: Giulio
authors.initials: G
authors.lastname: Conte
authors.affiliation: Cardiocentro Ticino, Lugano, Switzerland.
authors.forename: Boris
authors.initials: B
authors.lastname: Adjibodou
authors.affiliation: Cardiocentro Ticino, Lugano, Switzerland.
authors.forename: Stefano
authors.initials: S
authors.lastname: Svab
authors.affiliation: Cardiocentro Ticino, Lugano, Switzerland.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Bufalo
authors.affiliation: Cardiocentro Ticino, Lugano, Switzerland.
authors.forename: Tiziano
authors.initials: T
authors.lastname: Moccetti
authors.affiliation: Service of Biometry and Clinical Epidemiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Moreno
authors.initials: M
authors.lastname: Curti
authors.affiliation: Service of Biometry and Clinical Epidemiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Catherine
authors.initials: C
authors.lastname: Klersy
authors.affiliation: Cardiocentro Ticino, Lugano, Switzerland.
authors.forename: Angelo
authors.initials: A
authors.lastname: Auricchio
mesh_terms: D000368:Aged; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data / Q000639:trends; D004554:Electric Countershock / Q000295:instrumentation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods / Q000639:trends*; D055502:Secondary Prevention / Q000379:methods / Q000639:trends; D016019:Survival Analysis; D013557:Switzerland / Q000453:epidemiology; D017180:Tachycardia, Ventricular / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control
keywords: Implantable cardioverter-defibrillator (ICD); Out-of-hospital cardiac arrest; Risk stratification; Secondary prevention; Ventricular arrhythmia