In patients with ICDs, the decrease in R-wave amplitude at 5 years was significantly greater in those with ARVC (-3.3 mV) compared to controls without structural heart disease (1.3 mV).
Observational (n=50)
No
Does right ventricular apex ICD lead implantation maintain stable intracardiac parameters over 5 years in patients with ARVC and HCM compared to controls without structural heart disease?
In patients with ARVC, right ventricular apex ICD leads show significant deterioration in R-wave amplitude over 5 years compared to controls, suggesting the RV septum may be a preferable implantation site.
Absolute Event Rate: -3.3% vs 1.3%
p-value: p=0.012
Patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and hypertrophic cardiomyopathy (HCM) implanted with implantable cardioverter-defibrillators (ICDs) may show a large decrease in R-wave amplitude during long-term follow-up. However, it is unclear whether this decrease is higher in these patients than in those without structural heart disease. This study investigated ICD-lead intracardiac parameters over a long duration in patients with ARVC and HCM and compared these parameters with those of a control group. We included 50 patients (mean age, 55.2 ± 17.2 years; 26% female) with ICD leads in the right ventricular apex, and compared 7 ARVC and 14 HCM patients with 29 control patients without structural heart disease. ICD-lead parameters, including R-wave amplitude, pacing threshold, and impedance during follow-up, were compared. The difference in these parameters between the time of implantation and year 5 were also compared. There were no significant differences in R-wave amplitude at implantation among the 3 groups. The change in R-wave amplitude between the time of implantation and year 5 was significantly greater in the ARVC group (-3.3 ± 5.4 mV, P = 0.012) in comparison to the control group (1.3 ± 2.8 mV); the HCM group showed no significant difference (-0.4 ± 2.3 mV, P = 0.06). Thus, in the ARVC group, R-wave amplitude at year 5 was significantly lower than that in the control group (5.7 ± 4.8 mV versus 12.5 ± 4.5 mV, P = 0.001). In ARVC patients with ICDs, ventricular sensing is likely to deteriorate during long-term follow-up; however, in HCM patients, sensing may not deteriorate.
Sagawa et al. (Thu,) conducted a observational in Arrhythmogenic right ventricular cardiomyopathy and hypertrophic cardiomyopathy (n=50). Arrhythmogenic right ventricular cardiomyopathy (ARVC) vs. No structural heart disease was evaluated on Change in R-wave amplitude between implantation and year 5 (mV) (p=0.012). In patients with ICDs, the decrease in R-wave amplitude at 5 years was significantly greater in those with ARVC (-3.3 mV) compared to controls without structural heart disease (1.3 mV).