Korean Circ J.  2017 Jan;47(1):72-81. 10.4070/kcj.2016.0242.

Effectiveness of Implantable Cardioverter-Defibrillator Therapy for Heart Failure Patients according to Ischemic or Non-Ischemic Etiology in Korea

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea. dgshin@med.yu.ac.kr
  • 2Division of Cardiology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
  • 3Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
  • 4Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
  • 5Division of Cardiology, Department of Internal Medicine, Catholic University Medical Center, Daegu, Korea.
  • 6Cardiovascular Center, Andong Medical Group, Andong, Korea.
  • 7Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 8Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.
  • 9Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea.

Abstract

BACKGROUND AND OBJECTIVES
This study was performed to describe clinical characteristics of patients with left ventriculars (LV) dysfunction and implantable cardioverter-defibrillator (ICD), and to evaluate the effect of ICD therapy on survival in Yeongnam province of Korea.
SUBJECTS AND METHODS
From a community-based device registry (9 centers, Yeongnam province, from November 1999 to September 2012), 146 patients with LV dysfunction and an ICD implanted for primary or secondary prophylaxis, were analyzed. The patients were divided into two groups, based on the etiology (73 with ischemic cardiomyopathy and 73 with non-ischemic cardiomyopathy), and indication for the device implantation (36 for primary prevention and 110 for secondary prevention). The cumulative first shock rate, all cause death, and type and mode of death, were determined according to the etiology and indication.
RESULTS
Over a mean follow-up of 3.5 years, the overall ICD shock rate was about 39.0%. ICD shock therapy was significantly more frequent in the secondary prevention group (46.4% vs. 16.7%, p=0.002). The cumulative probability of a first appropriate shock was higher in the secondary prevention group (p=0.015). There was no significant difference in the all-cause death, cardiac death, and mode of death between the groups according to the etiology and indication.
CONCLUSION
Studies from this multicenter regional registry data shows that in both ischemic and non-ischemic cardiomyopathy patients, the ICD shock therapy rate was higher in the secondary prevention group than primary prevention group.

Keyword

Implantable cardioverter-defibrillator; Left ventricular dysfunction; Mortality; Heart failure
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