Prophylactic implantation of cardioverter-defibrillator in patients with severe cardiac amyloidosis and high risk for sudden cardiac death

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

“…Zgon często przypisuje się rozkojarzeniu elektromechanicznemu, ale opisywano przypadki skutecznego przerywania VA za pomocą ICD [408]. Komorowe zaburzenia rytmu podczas ambulatoryjnego monitorowania EKG stwierdza się u > 25% pacjentów z amyloidozą serca [409][410][411], ale wydaje się, że ich występowanie nie pozwala przewidywać SCD.…”

Current status of hematopoietic cell transplantation in the treatment of systemic amyloid light-chain amyloidosis

“…Our center has performed prophylactic implantation of cardioverter-defibrillator in 19 AL patients. 61 Two patients with ventricular tachyarrhythmias were treated successfully, but six patients died of electro-mechanic dissociation, which is a common cause of sudden cardiac death in AL patients. Whether prophylactic implantation of defibrillators reduces the rate of cardiac complications during HDM or afterward has still to be determined.…”

Treatment of End Stage Heart Failure Related to Cardiac Amyloidosis

“…However, it is presently thought that the cause of death is less often rapid ventricular arrhythmias but may include electromechanical dissociation [111] and advanced heart block. Among 19 patients with either non-sustained ventricular tachycardia or high grade ventricular arrhythmia treated with an ICD only 2 received appropriate shocks for sustained VT, while 6 died of electromechanical dissociation [112]. Thus, there seems to be little role for implantable pacemakers in cardiac amyloid patients, unless a sustained ventricular arrhythmia was documented.…”