Document Detail

Prophylactic implantable cardioverter defibrillator therapy in dilated cardiomyopathy: impact of left ventricular function.
MedLine Citation:
PMID:  16516695     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The value of an implantable cardioverter defibrillator (ICD) for primary prevention in dilated cardiomyopathy (DCM) is unclear, as randomized trials could not show a survival benefit compared to drug therapy. It has not been investigated if patients with a very poor left ventricular function (LVEF) could profit from an ICD. METHODS: Consecutive patients with DCM who received an ICD between December 1996 and November 2003 were included in this analysis. Patients were divided in group A (secondary prevention) and group B (primary prevention). Both groups were stratified in subgroups with left ventricular ejection fraction (LVEF) below and above 20%. RESULTS: Fifty eight patients were included (male 50, age 56.4+/-12.7 years). Follow-up was 34+/-19 months. There was no difference regarding death (18% vs. 11%), but significant differences (p value <0.05) regarding any adverse events (55% vs. 22%), any ICD intervention (48% vs. 17%) and ICD interventions for life-threatening arrhythmias (27% vs. 0%) between group A and B. LVEF was not predictive for events in group A, whereas in group B only patients with a LVEF <20% had events (p value 0.02). Over time there was an increase of the LVEF of more than 15% determined by echocardiography in 36% of patients, significantly more often in group B. CONCLUSIONS: Indication for primary prevention with an ICD in DCM should be made with caution. Larger studies are needed to determine if patients with LVEF of <20% might benefit from an ICD.
Beat A Schaer; Peter Ammann; Christian Sticherling; Michael J Zellweger; Thomas A Cron; Stefan Osswald
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  108     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-06     Completed Date:  2006-08-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  26-30     Citation Subset:  IM    
Department of Cardiology, University Hospital, Petersgraben 4, 4031 Basel, Switzerland.
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MeSH Terms
Arrhythmias, Cardiac / therapy
Cardiomyopathy, Dilated / complications,  mortality,  therapy*
Death, Sudden, Cardiac / etiology,  prevention & control*
Defibrillators, Implantable*
Follow-Up Studies
Middle Aged
Retrospective Studies
Survival Analysis
Ventricular Dysfunction, Left / complications,  mortality,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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