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)
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 et al. (Sun,) conducted a observational in Survivors of arrhythmic cardiac arrests (n=52). Implantation of an automatic defibrillator vs. Expected mortality without automatic defibrillator was evaluated on 1-year total mortality rate (52% decrease). 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.