Implantation of an automatic defibrillator in survivors of arrhythmic cardiac arrests resulted in a 22.9% 1-year total mortality rate, an estimated 52% decrease compared to the expected 48% mortality.
Observational (n=52)
Does implantation of an automatic defibrillator improve 1-year survival in patients who survived several arrhythmic cardiac arrests?
Implantation of an automatic defibrillator in high-risk patients surviving arrhythmic cardiac arrests substantially decreases 1-year mortality compared to expected rates.
Effect estimate: 52% decrease
Absolute Event Rate: 22.9% vs 48%
Fifty-two patients who survived several arrhythmic cardiac arrests had implantation of an automatic defibrillator along with additional cardiovascular surgery as indicated. The mean follow-up was 14.4 months and the longest was 3 years. In the hospital, the implanted devices identified and reverted 82 episodes of spontaneous and 81 of 99 episodes of induced malignant tachyarrhythmias. There were 62 automatic resuscitations in 17 patients outside the hospital. Twelve patients died; four of the deaths were not witnessed. These deaths represent a 22.9% total and 8.5% sudden-death 1-year mortality rate. Because the expected 1-year mortality in patients without the automatic defibrillator was calculated to be 48%, there was an estimated 52% decrease in anticipated total deaths. The automatic implantable defibrillator can identify and correct potentially lethal ventricular tachyarrhythmias, leading to a substantial increase in 1-year survival in properly selected high-risk patients.
Mirowskiら（Sun）は、心室性不整脈による心停止の生存者（n=52）を対象に観察研究を行った。自動除細動器の植え込みと、無自動除細動器の期待死亡率が1年の総死亡率（52%の減少）に対して評価された。心室性不整脈による心停止の生存者における自動除細動器の植え込みは、推定48%の死亡率に比べて22.9%の1年総死亡率をもたらした。