Clinical experience, complications, and survival in 70 patients with the automatic implantable cardioverter/defibrillator.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Ventricular tachycardia or fibrillation (n=70). Intervention: Automatic implantable cardioverter/defibrillator. Primary outcome: 12-month cardiovascular survival.

Debra S. Echt; Kathryn Armstrong; Paula Schmidt; P.E. Oyer; Edward B. Stinson; Roger A. Winkle

doi:10.1161/01.cir.71.2.289

February 1, 1985Circulation

Clinical experience, complications, and survival in 70 patients with the automatic implantable cardioverter/defibrillator.

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Key result

The automatic implantable cardioverter/defibrillator yielded 6- and 12-month cardiovascular survival rates of 95.0% and 89.9%, and a sudden death survival rate of 98.2%.

Why the study?

Does the automatic implantable cardioverter/defibrillator improve survival in patients with refractory ventricular tachycardia or fibrillation?

Key Points

To assess clinical performance, device-related complications, and long-term survival in patients receiving an automatic implantable cardioverter/defibrillator for drug-refractory ventricular tachyarrhythmias.
Evaluated 70 patients (mean prior arrhythmic episodes 3.1 ± 2.3; mean prior drug failures 4.0 ± 2.1) presenting with sustained ventricular tachycardia (n=32), ventricular fibrillation (n=20), or both (n=18).
Implanted original (n=5) or modified second-generation bipolar rate-sensing devices (n=72) in 68 patients, tracking outcomes over a mean follow-up of 8.9 ± 7.7 months (range 1 to 33 months).
A total of 37 patients experienced 463 discharges; documented complications included lead malfunctions (n=6), inadequate energy requiring explantation (n=2), pocket infection (n=1), and postoperative death (n=1).
Life-table analysis demonstrated a 6-month and 12-month cardiovascular survival rate of 95.0% and 89.9%, respectively, and an overall sudden death survival rate of 98.2%.

Study Design

Type

Observational (n=70)

Structured PICO

Does the automatic implantable cardioverter/defibrillator improve survival in patients with refractory ventricular tachycardia or fibrillation?

P

Population

70 patients with refractory ventricular tachycardia or fibrillation (sustained VT in 32, VF in 20, both in 18) who had survived prior arrhythmic episodes and failed antiarrhythmic drugs.

I

Intervention

Automatic implantable cardioverter/defibrillator (AICD)

O

Outcome

Cardiovascular survival and sudden death survival at 6 and 12 monthshard clinical

The automatic implantable cardioverter/defibrillator provides high rates of cardiovascular and sudden death survival in patients with refractory, life-threatening ventricular arrhythmias.

Limitations

Inability to determine the precise reason for most discharges
Unpleasant nature of the discharges

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Implication

Supports ICD evaluation in refractory VT/VF; leaves open randomized confirmation of survival benefit.

Abstract

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Discussion

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Cite This Study

Echt et al. (1985) conducted an observational in Ventricular tachycardia or fibrillation (n=70). Automatic implantable cardioverter/defibrillator was evaluated on 12-month cardiovascular survival. The automatic implantable cardioverter/defibrillator yielded 6- and 12-month cardiovascular survival rates of 95.0% and 89.9%, and a sudden death survival rate of 98.2%.

synapsesocial.com/papers/6a153712cb0379474a820418 https://doi.org/10.1161/01.cir.71.2.289

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Clinical experience, complications, and survival in 70 patients with the automatic implantable cardioverter/defibrillator.

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Clinical experience, complications, and survival in 70 patients with the automatic implantable cardioverter/defibrillator.

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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