Key result
Among Korean patients undergoing ICD implantation, the primary composite outcome occurred in 28.6% of the primary prevention group and 33.2% of the secondary prevention group (P=0.44).
Why the study?
Does ICD implantation for primary prevention compared to secondary prevention result in different rates of cardiac death, appropriate shock, or antitachycardia pacing in Korean patients?
Observational (n=365)
No
Does ICD implantation for primary prevention compared to secondary prevention result in different rates of cardiac death, appropriate shock, or antitachycardia pacing in Korean patients?
Absolute Event Rate: 28.6% vs 33.2%
p-value: p=0.44
In a Korean single-center registry, ICD implantation showed similar rates of the primary composite outcome (cardiac death, appropriate shock, or ATP) between primary and secondary prevention cohorts, though inappropriate shocks were common.
Similar outcomes by prevention indication; leaves open whether indication affects ICD prognosis in Korean patients.
The safety and efficacy of implantable cardioverter-defibrillator (ICD) for Korean is unclear. We investigated the clinical characteristics and outcomes of Korean patients undergoing ICD for primary or secondary prevention. Materials and Methods: From October 1999 to December 2016, 396 cases (365 patients) of ICD implantation were performed: Baseline characteristics, procedural findings, and clinical outcome data were collected retrospectively from our ICD registry. The primary outcome was composite of cardiac death, appropriate shock or antitachycardia pacing. Results: Among 365 patients, 91 patients (25.9%) had ICD for primary prevention and 274 patients (75.1%) were for secondary prevention (51.217.10 years, male was 80.8%). The median follow-up period was 3.1 years (interquartile range: 1.6-6.0 days). The most prevalent etiology was dilated cardiomyopathy (46.2%) in the primary prevention and idiopathic ventricular tachycardia or fibrillation (24.4%) in the secondary prevention. The primary outcome was noted in 28.6% of the primary prevention and 33.2% of the secondary prevention (P=0.44). The rate of cardiac death was 2.2% in the primary prevention and 1.8% in the secondary prevention (P=1.00). The hospitalization due to heart failure was higher in the primary prevention compared with the secondary prevention (23.1% versus 13.5%, P=0.03). ICD therapy occurred in 134 patients (36.7%). Among them, 60 patients (44.8% of ICD therapy) experienced inappropriate shock. The most common cause of inappropriate shock was atrial fibrillation of flutter (AF/AFL).
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Hwang et al. (2017) conducted an observational in Implantable cardioverter-defibrillator indication (n=365). ICD for primary prevention vs. ICD for secondary prevention was evaluated on Composite of cardiac death, appropriate shock or antitachycardia pacing (p=0.44). Among Korean patients undergoing ICD implantation, the primary composite outcome occurred in 28.6% of the primary prevention group and 33.2% of the secondary prevention group (P=0.44).
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