Summary:
Objective: The purpose of this study was to examine the clinical effectiveness
of implantable cardiovascular defibrillator (ICD) use for secondary and primary
prevention of sudden cardiac death, in a tertiary University Hospital in
Attica, Greece.
Methods: The files of the arrhythmic clinic of the University Hospital
“Attikon” where studied. We recorded and analyzed all data concerning patients
that were observed in a regular basis in this clinic and have implanted ICD
during a three year period (2010 – 2012).
Data/ results: During the three year period (2010-2012) one hundred eighty
eight (188) cardiovascular defibrillators (58,9 % for primary and 41,1 % for
secondary prevention) were implanted in patients on average age of fifty eight
years (58±10 years) (153 males / 32 females). ICD was implanted in one hundred
forty three (143) patients and a biventricular defibrillator (CRT – D) was
implanted in the other forty two (42) patients. Most common underlying disease
was ischemic cardiomyopathy (47,6%) followed by dilated cardiomyopathy (27,6%)
in both patient groups (primary and secondary prevention).
Proper activation (appropriate shock, ATP) of ICD was recorded in a 37,3% of
all cases, 25,7% for primary and 34,2% for secondary prevention, following
observation of on average thirty six months (36 ± 12).
Non-proper activation (inappropriate shock) of ICD was recorded in a 17,8% of
cases mostly due to atrial fibrillation and sinus tachycardia episodes.
Conclusions: The proper activation percentage in combination with the few
complications that were observed by the implantation of the device, reflect the
effectiveness of ICD therapy under the particular circumstances of clinical
practice in the Implantation Center of “Attikon” Hospital.
Keywords:
Ventricular tachycardia, Sudden cardiac death, Primary-secondary prevention, Implantable -cardioverter – defibrillator, Appropriate- inappropriate shock
