Implantable Cardioverter/Defibrillators in the Primary Prevention of Sudden Death: We Know What to Do but Are We Doing It?

2012 ◽  
Vol 172 (1) ◽  
Author(s):  
Paul J. Hauptman
Keyword(s):  
Primary Prevention ◽  
Sudden Death ◽  
Implantable Cardioverter Defibrillators ◽  
Cardioverter Defibrillators

Implantable cardioverter defibrillators for primary prevention of sudden death in hypertrophic cardiomyopathy

2016 ◽  
Vol 17 (6) ◽  
pp. 433-439 ◽  
Author(s):  
Dimitrios M. Konstantinou ◽  
Georgios K. Efthimiadis ◽  
Vassilios Vassilikos ◽  
Stylianos Paraskevaidis ◽  
Efstathios Pagourelias ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Primary Prevention ◽  
Sudden Death ◽  
Implantable Cardioverter Defibrillators ◽  
Cardioverter Defibrillators

Abstract 122: Comparative Effectiveness of Primary Prevention Implantable Cardioverter-Defibrillators in Older Adults With Diabetes Mellitus: Insights From the Get With the Guidelines - Heart Failure Registry

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Abhinav Sharma ◽  
Jingjing Wu ◽  
Adrian F Hernandez ◽  
G. M Felker ◽  
Sana Al-Khatib ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Primary Prevention ◽  
Sudden Death ◽  
Guideline Recommendation ◽  
Study Cohort ◽  
Current Guideline ◽  
Implantable Cardioverter Defibrillators ◽  
Increased Risk ◽  
Cardioverter Defibrillators

Introduction: Patients with diabetes mellitus (DM) and heart failure with reduced ejection fraction (HFrEF) are at increased risk of sudden death. However, given the burden of competing causes of death in patients with DM, therapies to reduce the risk of sudden death may have reduced efficacy. We aimed to assess the effectiveness of implantable cardioverter-defibrillators (ICDs) in a large US registry. Methods: We linked data from the GWTG-HF registry to the Centers for Medicare/Medicaid Services claims (January 2010 to December 2014). Using Cox proportional hazard models with propensity score matching for baseline covariates, among patients with and without DM, we compared patients who received an ICD (or were prescribed an ICD at discharge) to those without an ICD. The primary outcome was all-cause mortality. Results: Among the 17,186 patients in our study cohort, 6683 (38%) had DM. For patients with DM, those with an ICD (n=663), compared to those without and ICD, were younger (74.0 vs. 78.0 years of age), more likely to be male (66.3% vs. 55.7%) and more likely to have coronary disease (67.8% vs. 60.4%) Similar trends were seen among patients without DM (n=1,031). Among patients with DM, in matched cohorts, an ICD was associated with a reduced risk of mortality (54.4% vs. 60.0%; adjusted HR [aHR] 0.74, 95% CI 0.65-0.83; figure panel A). Similar results for mortality were seen in patients without DM (47.4% vs. 57.0%; aHR 0.68, 95% CI 0.61-0.75; figure panel B). Diabetes did not modify the relationship between ICD and mortality (interaction p-value = 0.24). Conclusion: Among patients with HFrEF, primary prevention ICD was associated with reduced mortality in patients with and without diabetes. These findings support current guideline recommendation for primary prevention ICDs among eligible patients with DM.

Abstract 12621: Gender Differences Among Implantable Cardioverter Defibrillators Recipients in the Setting of Primary Prevention

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Eloi Marijon ◽  
Rui Providencia ◽  
Pascal Defaye ◽  
Didier Klug ◽  
Daniel Gras ◽  
...  
Keyword(s):  
Primary Prevention ◽  
Dilated Cardiomyopathy ◽  
Specific Interaction ◽  
Severe Heart Failure ◽  
Real Life ◽  
Functional Class ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Icd Implantation ◽  
Cardioverter Defibrillators

Background: Data regarding sex specificities in the use, benefits and complications of implantable cardioverter-defibrillators (ICDs) in primary prevention in the real-world European setting are sparse. Methods: Using a large multicentric cohort of consecutive patients referred for ICD implantation for primary prevention (2002-2012), in the setting of coronary artery disease or dilated cardiomyopathy, we examined potential sex differences in subjects’ characteristics and outcomes. Results: Of 5,539 patients, only 837 (15.1%) were women and 53.8% received cardiac resynchronization therapy (CRT-D). Compared to men, women presented a significantly higher proportion of dilated cardiomyopathy (60.2% vs. 36.2%, P120ms: 74.6% vs. 68.5%, P=0.003), higher New York Heart Association functional class (2.5±0.7 vs. 2.4±0.7, P=0.003) and lower prevalence of atrial fibrillation (18.7% vs. 24.9%, P<0.001). During a 16,786 patient-years follow-up, overall, fewer appropriate therapies were observed in women (HR = 0.59, CI95% 0.45-0.76; P<0.001). By contrast, no sex-specific interaction was observed for inappropriate shocks (OR for women = 1.00, 95%CI 0.74-1.35, P=0.997) and mortality (HR = 0.87; 95%CI 0.66-1.15, P=0.324), with similar patterns of cause of deaths. Conclusion: In our real life registry, women account for the minority of ICD recipients. While female ICD recipients present with features of more severe heart failure in the setting of primary prevention of sudden cardiac death, we observed they have a 40% lower incidence of appropriate therapies.

scholarly journals Age and Outcomes of Primary Prevention Implantable Cardioverter-Defibrillators in Patients With Nonischemic Systolic Heart Failure

Circulation ◽  
2017 ◽  
Vol 136 (19) ◽  
pp. 1772-1780 ◽  
Author(s):  
Marie Bayer Elming ◽  
Jens C. Nielsen ◽  
Jens Haarbo ◽  
Lars Videbæk ◽  
Eva Korup ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Prevention ◽  
Systolic Heart Failure ◽  
Implantable Cardioverter Defibrillators ◽  
Cardioverter Defibrillators
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