Long-term follow-up of patients treated with ICD: Benefit in patients with preserved left ventricular function

Abstract

Patients with preserved left ventricular function are excellent candidates for ICD, with life-saving ICD therapies in a substantial proportion, low mortality and good quality of life.

Implantable cardioverter‐defibrillators: a long‐term view

“…The Canadian Implantable Defibrillator Study has reported mortality rate of 27% at 5.6 years, 11 while long‐term follow up of primary‐prevention trials demonstrated 49% mortality at 8 years in the Multicenter Automatic Defibrillator Implantation Trial II 15 and 21% at 3.8 years in the Sudden Cardiac Death in Heart Failure Trial 13 . Observational studies reporting long‐time outcomes have also tended to report a higher mortality rate than seen in our series 16,17,19 . There are several possible explanations for our lower mortality.…”

“…Long‐term follow‐up data have been published from a number of the landmark trials of ICD therapy 11–15 . However, relatively few reports have been published on the long‐term outcomes in ‘real life’ ICD populations consisting of both primary and secondary‐prevention patients who are not involved in clinical trials 16–20 . Most of these reports originate from either Europe or the United States.…”

The clinical course of patients with implantable cardioverter-defibrillators: Extended experience on clinical outcome, device replacements, and device-related complications

“…Other observational studies reported similar mortality rates, although most follow-up periods did not exceed 5 years in these studies. [10][11][12][13][14][15] The incidence of all-cause mortality of ICD recipients was higher in the secondary prevention population; this has not been described before and was only apparent after stratifying for ICD and CRT-D treatments. However, closely reviewing the 3-year mortality rates observed in primary and secondary prevention trials demonstrates a comparable trend.…”

“…[11][12][13]20 Appropriate shocks were observed in 24% of the primary prevention patients and 47% of the secondary prevention patients over 12 years, which seems comparable with the 28% appropriate shocks reported by Ronn et al after 6 years in secondary prevention patients. 10 Furthermore, the large ALTITUDE registry reported 33%-38% appropriate shocks after 5 years. However, comparisons with this registry should be interpreted with caution since the distribution of primary and secondary prevention patients is unknown.…”

“…9 Followup in observational studies does not exceed 5 years, while many patients live more than a decade after device implantation. [10][11][12][13][14][15] Therefore, the aim of the present study was to provide an overview of the long-term clinical outcome of ICD and CRT-D recipients in a large cohort outside the setting of a clinical trial. Clinical outcome includes all-cause mortality, device therapy, device replacements, and device-related complications.…”