Aim. To study clinical and anamnestic data of patients with implantable cardioverterdefibrillators (ICD) for primary or secondary prevention of sudden cardiac death (SCD) based on the data from the Kuzbass ICD registry.Methods. Retrospective analysis of demographic, clinical and anamnestic data from the “Kuzbass Registry of Patients with Implanted Cardioverter-Defibrillator”, which includes 286 patients admitted at the Kuzbass Cardiology Center in 2015–2019, was carried out.Results. The age of patients included in the registry was 59 (53; 66) years, 239 (83.6%) were men; all patients were diagnosed with heart failure. ICD for primary prevention of SCD was prescribed in 171 (63.6%) patients (group 1) and for secondary prevention in 98 (36.4%) patients (group 2). The groups were comparable in age, sex, main nosology (coronary artery disease), left ventricular ejection fraction (31.4 (26; 35) and 30 (10; 68)%, p = 0.389). Compared with the group 2, the group 1 had fewer working patients, higher incidence of heart defects, severe heart failure, higher incidence of paroxysmal supraventricular tachycardia (68.7% versus 44.8%, p = 0.001), and higher rates of revascularization (48, 9% and 31.7%, respectively, p = 0.006). Before ICD implantation for heart failure, 210 (73.4%) patients were receiving renin angiotensin aldosterone system inhibitors, 259 (90.6%) – beta-blockers, 167 (58.4%) – mineralocorticoid receptor antagonists. There were no differences in prescribed treatment between the groups. Only 137 (47.9%) patients, 86 (47.3%) patients in the group 1 and 51 (49.0%) patients in the group 2 received triple neurohormonal blockade. Remote monitoring was used only within the framework of research programs.Conclusion. The primary cohort of patients with ICD is the primary SCD prevention group. Regardless of the type of SCD prevention, the underlying disease is coronary artery disease. Current guidelines for optimal drug therapy and myocardial revascularization are not always followed prior to ICD implantation. The creation of registries of patients with ICD is an effective way to identify existing problems in ICD patient selection and to optimize follow-up and treatment.

Aim    To analyze long-term outcomes by results of the prospective part of the Kuban registry of patients with an implantable cardioverter defibrillator (ICD).Material and methods    A prospective analysis of the incidence of hard endpoints and changes in the condition was performed for 260 patients with ICD successively added to the Registry of Patients with Implantable Cardioverter Defibrillator” from 2015 through 2019.Results    At the time of ICD implantation, all patients had chronic heart failure (CHF), mostly of ischemic etiology with a low left ventricular ejection fraction (LVEF); median LVEF was 30 (25; 36.5) %. 54 of 266 (21.9 %) patients died by 2021;  17 of them (31.5 %) died in the hospital; in 76.5 % of cases, death was caused by acute decompensated heart failure (HF). 139 (53.5%) patients were readmitted; 66 (25.4 %) hospitalizations were related with ICDs (lead revision or reimplantation); acute cardiovascular events developed in 38 (14.6 %) patients; 12 (4.6%) patients underwent percutaneous coronary interventions; orthotopic heart transplantation was performed for 4 patients. ICD shocks were recorded in 27 (10.4 %) patients. After the ICD implantation, median LVEF remained unchanged, 31 (25; 42) vs. 30 (25; 36.5) % (р>0.05). However, both objective and subjective HF symptoms worsened. Thus, the number of patients with IIB stage CHF increased from 29.6  to 88.8 % (р<0.01) and with NYHA III CHF from 24.2  to 34.5 % (p<0.05). 80 (30.8%) patients visited cardiologists on a regular basis. Only 7.3% of patients received an optimal drug therapy. During the observation period, the rate of beta-blocker treatment considerably decreased, from 90.6  to 64.3 % (р<0.01), and the rate of the mineralocorticoid receptor antagonist treatment decreased from 50.8  to 17.4 % (р<0.01). The rate of the diuretic treatment was inconsistent with the severity of patients’ condition.Conclusion    Most of the problems the patients encountered after the ICD implantation were related with an inadequate treatment of the underlying disease. Since the majority of patients with ICD have a low LVEF, it is essential to focus on prescribing an optimal drug therapy and maintaining compliance with this therapy.