Implantable Defibrillator Therapy in Cardiac Arrest Survivors With a Reversible Cause

Abstract

In survivors of SCA because of a reversible and correctable cause, ICD therapy is associated with lower all-cause mortality except if the SCA was because of myocardial infarction. These data deserve further investigation in a prospective multicenter randomized controlled trial, as they may have important and immediate clinical implications.

Implantable cardioverter‐defibrillator therapy in device recipients who survived a cardiac arrest associated with a reversible cause

“…Taken in the context of our previous data demonstrating a survival benefit associated with the ICD in SCA patients with a reversible cause other than MI/ischemia, 6 these results strongly suggest that the ICD may decrease mortality in survivors of SCA not related to MI/ischemia. Taken in the context of our previous data demonstrating a survival benefit associated with the ICD in SCA patients with a reversible cause other than MI/ischemia, 6 these results strongly suggest that the ICD may decrease mortality in survivors of SCA not related to MI/ischemia.…”

“…As previously described, 6 we conducted this retrospective, observational study at the hospitals of University of Pittsburgh Medical Center. This study was approved by the institutional review board of the University of Pittsburgh.…”

“…6 Details of patients' characteristics included demographics, laboratory data, comorbid conditions, as well as electrocardiographic and echocardiographic data. ICD implantation had been previously shown by our group to be associated with improved longterm all-cause mortality in survivors of SCA associated with a reversible cause other than MI/ischemia.…”

“…6 These results persisted after adjustments for any unbalanced covariates between ICD recipients and nonrecipients. 6 These results persisted after adjustments for any unbalanced covariates between ICD recipients and nonrecipients.…”

“…Our group has recently demonstrated that the use of ICDs in survivors of SCA even in the context of a reversible cause is associated with mortality benefit, except in patients whose reversible cause was due to myocardial ischemia or infarction (MI/ischemia) that was treated with coronary revascularization. 6 These results persisted after adjustments for any unbalanced covariates between ICD recipients and nonrecipients. Given the retrospective nature of that study, it remains uncertain whether the survival benefit in ICD recipients after SCA due to a reversible cause is due to the ICD itself or whether it is a mere association due to residual bias that could not be accounted for statistically.…”