Evaluation of long-term outcomes in ischemic and nonischemic dilated cardiomyopathies with ICD implantation (The single-center study)
A Yetkin, H Yorgun, E B Kaya, M L Sahiner, C Coteli, A Kivrak, A H Ates, U Canpolat, E Atalar, N Ozer, K AytemirAbstract
Introduction and Purpose
The aim of this study was to compare the long-term follow-up results of patients who underwent implantable cardioverter defibrillator (ICD) implantation for ischemic and nonischemic dilated cardiomyopathy, to determine the time to ICD therapy, and to evaluate the clinical factors affecting this time.
Methods
Patients aged ≥18 years who underwent ICD implantation between January 2015 and July 2024 were retrospectively analyzed. Patients were grouped as ischemic cardiomyopathy (n=686) and nonischemic dilated cardiomyopathy (n=441). Time to ICD therapy including shocks or antitachycardia pacing for ventricular tachycardia (VT) and ventricular fibrillation (VF), appropriate/inappropriate shock rates, and event-free survival were analyzed.
Results
The mean follow-up period was 38.1 months. A total of 1127 patients were included in the study with 846 males (% 75.1) and 281 females (24.9%). The mean age of the patients was 63 ± 14 years. The median follow-up period for patients with ICMP and NIDCMP was 34 ± 28 months. ICD therapy was recorded in 161 (% 23.4) patients with ICMP and 91 (% 20.6) patients with NIDCMP during the follow-up period. No significant difference in VT/VF-free survival was observed during the follow-up period in either group (p=0.27) (Figure 1). The appropriate shock rate for VT/VF did not differ significantly in patients with NIDCMP compared to patients with ICMP (16.1% vs. 12.9%; p=0.15). In the primary prophylaxis group, ICD therapy was recorded in 90/599 (15.1%) patients with ICMP and 39/370 (10.5%) patients with NIDCMP, (p=0.045). ICD therapy-free survival in primary prophylaxis patients did not differ significantly between the ICMP and NIDCMP groups (p=0.11). Among all group, 73 (16.5%) patients in the NIDCMP group and 71(10.3%) patients in the ICMP group received inappropriate shocks (p<0.01).
Conclusions
In the primary prophylaxis group, patients with ICMP received more therapy than patients with NIDCMP. VT/VF-free survival was similar between the groups during the follow-up.Figure 1