Key result
Over a mean follow-up of 12.4 years, mortality was significantly higher in secondary prevention ICD recipients compared to primary prevention recipients (41.1% vs 19.7%, p=0.008).
Cohort (n=854)
No
Long-term real-world data from a single center confirm the high efficacy and safety of ICDs, with expected rates of mortality and appropriate therapies based on the prevention indication.
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Should not yet change ICD selection or follow-up; leaves open whether indication or unmeasured risk drives long-term mortality in Level 5 data.
PURPOSE: The aim of the current study is to disseminate long-term "real-world" data on mortality and device therapies in primary and secondary prevention implantable cardioverter defibrillator (ICD) recipients on the island of Crete. METHODS: We analyzed data for all consecutive patients who received an ICD in our tertiary university hospital from 1993 until December 2013. Follow-up visits were performed every 6 months or more frequently when indicated. Survival status was recorded, and all stored episodes during interrogation were registered and classified as appropriate or inappropriate. RESULTS: In total, 854 patients received an ICD; 623 (73%) for primary and 231 (27%) for secondary prevention. Most of these patients (490) suffered from ischemic cardiomyopathy. During the mean follow-up of 12.4±7.8 years, 218 (25.5%) patients died; 19.7% in the primary prevention group (p=0.008) and 41.1% in the secondary prevention group. Overall, 248 patients (29%) received appropriate therapy; however, the percentage was significantly higher in the secondary prevention group (44.2%) than in primary prevention group (23.4%). The cumulative incidence of inappropriate therapies during the mean follow-up period was 11.6%. Lead-related complications were noted in 49 patients (5.7%), while only 13 patients (1.5%) suffered device-related infections. CONCLUSIONS: The long-term data related to clinical outcomes in ICD recipients in our center are in accordance with those of other international centers and confirm the high efficacy and safety of these devices in preventing sudden cardiac death.
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Kanoupakis et al. (2016) conducted a cohort in Implantable cardioverter defibrillator (ICD) recipients (n=854). Secondary prevention ICD vs. Primary prevention ICD was evaluated on Mortality (p=0.008). Over a mean follow-up of 12.4 years, mortality was significantly higher in secondary prevention ICD recipients compared to primary prevention recipients (41.1% vs 19.7%, p=0.008).
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