Incidence of ICD shocks in patients recruited for ICD/CRT-D therapy across 15 countries from Africa, Middle East, Eastern Europe and the Commonwealth of Independent States

Introduction Implantable Cardioverter Defibrillators (ICDs) are well-established therapies in patients with heart failure who are at risk of sudden cardiac death (SCD). While numerous large-scale registries have been conducted in the United States and Western Europe, data from other regions remain limited. Purpose The MEAREE ICD registry was designed to collect real-world data on ICDs interventions in Middle East, Africa, East Europe, and the Commonwealth of Independent States (CIS) countries. Methods Twenty-seven Cardiology Departments in 15 countries prospectively enrolled and followed patients with ICDs. Investigators reviewed all delivered ICDs therapies and classified ICDs shocks as appropriate or inappropriate. Results Total of 700 patients (156 female, mean age 63±13 years) were enrolled between February 2022 and October 2023, all with at least one follow-up visit. ICD implant indication was SCD primary or secondary prevention in 519 (74.2%) and 181 (25.8%) patients respectively. Over a mean follow-up of 13±3 months (total follow-up = 735 years), appropriate ICD shock occurred in 30 patients (4.1 per 100 patient-years), in particular in 18 SCD secondary prevention patients (9.5 per 100 patient-years) and in 12 SCD primary prevention patients (2.2 per 100 patient-years). Inappropriate ICD shocks were reported in 15 patients (2.0 per 100 patient-years). Conclusion This large, prospective, real-world registry provides valuable insight into ICD therapies in contemporary ICD patient populations from Africa, Middle East, Eastern Europe and the CIS. These results confirm that ICDs provide protection from SCD, particularly within the first year post-implantation, in alignment with advancements in cardiac care.