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2018, Number 1

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Rev Mex Cardiol 2018; 29 (1)

Prognostic impact of defibrillator shocks in a Colombian cohort

Aristizábal AJM, Díaz-Martínez JC, Velásquez VJE, Marín VJE, Uribe AW, Duque RM

Language: English
References: 32
Page: 27-36
PDF size: 300.32 Kb.


ABSTRACT

Introduction: The implantable cardioverter defibrillator (ICD) has become the first-line treatment option for SCD prevention. In Colombia, while ICD therapy has been available for several years, extensive registries or studies documenting the impact of ICD therapy are lacking. Objective: To evaluate the association between appropriate and inappropriate ICD therapies and mortality in Colombian patients. Methods: Prospective observational cohort study including 530 patients with cardiomyopathy of varied etiology, from eight clinics in Medellin, Colombia, from 2013 to 2016. Adjusted and survival analyses were performed. Results: Of all participating patients, 72.1% were men, and median age was 64 years. Mean follow-up time was 1.5 ± 0.92 years, with a follow-up rate of 353.3 patients/year. The most common indication for ICD implantation was ischemic heart disease (48.7%), and indication of primary prevention (63.4%). Mortality was 12.8%, and patients with ischemic etiology had 1.8-times greater risk of death compared to non-ischemic patients. 14% of the patients received appropriate therapies, while 13.6% were inappropriate. There was a 65% greater risk of appropriate therapies in patients with ischemic heart disease. High blood pressure, being over 61 years of age, and having left ventricular ejection fraction ‹ 35%, were risk factors for death, while use of beta-blockers was associated with a reduced risk of death. Conclusions: The main indication for ICD was ischemic etiology and primary prevention. Mortality is higher in patients with ischemic etiology, who in addition have increased risk of presenting appropriate therapies. The frequency of device therapies was decreased compared to previous reports.


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