AIMS: The beneficial effects of implantable cardioverter defibrillators (ICDs) in primary and secondary prevention patients are well established. However, data on potential differences between both groups in mortality and ICD therapy rates during long-term follow-up are scarce. The aim of the study was to assess differences in mortality and ICD therapy between secondary and primary prevention ICD recipients. METHODS AND RESULTS: With the exception of patients with congenital monogenetic cardiac disease, all patients treated with an ICD, regardless of the underlying cardiac pathology, from 1996 to 2008 at the Leiden University Medical Center were included in the current analysis. The study population was grouped by the type of prevention (secondary or primary) for sudden cardiac death. The primary endpoint was all-cause mortality. The secondary endpoint was the occurrence of device therapy (appropriate or inappropriate). A total of 2134 (80% men, mean age 63 ± 12 years) ICD recipients were included. Of these, 1302 (61%) patients received an ICD for primary prevention of sudden cardiac death and 832 (39%) patients for secondary prevention. During a mean follow-up of 3.4 ± 2.8 years, 423 (20%) patients died. The 5-year cumulative incidence of mortality was 25% [95% confidence intervals (CI): 21-29%] for primary prevention patients and 23% (95% CI: 20-26%) for secondary prevention patients. Secondary prevention patients exhibited a 74% increased risk for appropriate therapy when compared with primary prevention patients [hazard ratios (HR): 1.7; P< 0.001]. A comparable risk for inappropriate shocks was observed (HR: 1.0; P= 0.9). CONCLUSION: During long-term follow-up, primary prevention patients exhibited a lower risk of appropriate therapy, but comparable mortality rates were observed between both groups. Both groups showed similar occurrence of inappropriate shocks.
AIMS: The beneficial effects of implantable cardioverter defibrillators (ICDs) in primary and secondary prevention patients are well established. However, data on potential differences between both groups in mortality and ICD therapy rates during long-term follow-up are scarce. The aim of the study was to assess differences in mortality and ICD therapy between secondary and primary prevention ICD recipients. METHODS AND RESULTS: With the exception of patients with congenital monogenetic cardiac disease, all patients treated with an ICD, regardless of the underlying cardiac pathology, from 1996 to 2008 at the Leiden University Medical Center were included in the current analysis. The study population was grouped by the type of prevention (secondary or primary) for sudden cardiac death. The primary endpoint was all-cause mortality. The secondary endpoint was the occurrence of device therapy (appropriate or inappropriate). A total of 2134 (80% men, mean age 63 ± 12 years) ICD recipients were included. Of these, 1302 (61%) patients received an ICD for primary prevention of sudden cardiac death and 832 (39%) patients for secondary prevention. During a mean follow-up of 3.4 ± 2.8 years, 423 (20%) patients died. The 5-year cumulative incidence of mortality was 25% [95% confidence intervals (CI): 21-29%] for primary prevention patients and 23% (95% CI: 20-26%) for secondary prevention patients. Secondary prevention patients exhibited a 74% increased risk for appropriate therapy when compared with primary prevention patients [hazard ratios (HR): 1.7; P< 0.001]. A comparable risk for inappropriate shocks was observed (HR: 1.0; P= 0.9). CONCLUSION: During long-term follow-up, primary prevention patients exhibited a lower risk of appropriate therapy, but comparable mortality rates were observed between both groups. Both groups showed similar occurrence of inappropriate shocks.
Authors: Aafke C van der Heijden; Johannes B van Rees; Wayne C Levy; Johanna G van der Bom; Suzanne C Cannegieter; Mihàly K de Bie; Lieselot van Erven; Martin J Schalij; C Jan Willem Borleffs Journal: Europace Date: 2017-01 Impact factor: 5.214
Authors: Kristina Wasmer; Julia Köbe; Dietrich Andresen; Ralf Zahn; Stefan G Spitzer; Joachim Jehle; Johannes Brachmann; Christoph Stellbrink; Eimo Martens; Matthias Hochadel; Jochen Senges; Helmut Klein; Lars Eckardt Journal: Clin Res Cardiol Date: 2013-03-30 Impact factor: 5.460
Authors: Tomas G Neilan; Hoshang Farhad; Thomas Mayrhofer; Ravi V Shah; John A Dodson; Siddique A Abbasi; Stephan B Danik; Daniel J Verdini; Michifumi Tokuda; Usha B Tedrow; Michael Jerosch-Herold; Udo Hoffmann; Brian B Ghoshhajra; William G Stevenson; Raymond Y Kwong Journal: JACC Cardiovasc Imaging Date: 2015-03-18
Authors: Jens Cosedis Nielsen; Yenn-Jiang Lin; Marcio Jansen de Oliveira Figueiredo; Alireza Sepehri Shamloo; Alberto Alfie; Serge Boveda; Nikolaos Dagres; Dario Di Toro; Lee L Eckhardt; Kenneth Ellenbogen; Carina Hardy; Takanori Ikeda; Aparna Jaswal; Elizabeth Kaufman; Andrew Krahn; Kengo Kusano; Valentina Kutyifa; Han S Lim; Gregory Y H Lip; Santiago Nava-Townsend; Hui-Nam Pak; Gerardo Rodríguez Diez; William Sauer; Anil Saxena; Jesper Hastrup Svendsen; Diego Vanegas; Marmar Vaseghi; Arthur Wilde; T Jared Bunch; Alfred E Buxton; Gonzalo Calvimontes; Tze-Fan Chao; Lars Eckardt; Heidi Estner; Anne M Gillis; Rodrigo Isa; Josef Kautzner; Philippe Maury; Joshua D Moss; Gi-Byung Nam; Brian Olshansky; Luis Fernando Pava Molano; Mauricio Pimentel; Mukund Prabhu; Wendy S Tzou; Philipp Sommer; Janice Swampillai; Alejandro Vidal; Thomas Deneke; Gerhard Hindricks; Christophe Leclercq Journal: Europace Date: 2020-08-01 Impact factor: 5.214