Abstract
Aims
Several trials demonstrated the life saving role of implantable cardioverter-defibrillators
(ICD) in primary prevention of sudden cardiac death (SCD). The aim was to evaluate
the clinical characteristics and 4-year outcome of consecutive patients treated in
clinical practice by prophylactic ICD implantation on the basis of class I recommendations
and up-to-date ICD programming.
Methods and results
IRIDE multi-center, prospective and observational study enrolled 604 consecutive patients
(mean age: 66±10 years) treated by ICD between 01/01/2006 and 30/06/2010. Main characteristics were
similarly distributed among the inclusion criteria of MADIT II (24%), SCD-HeFT (24%),
COMPANION (26%) and MADIT-CRT (18%) trials, while a small number of patients met the
MUSTT and MADIT (7%) inclusion criteria. Single-chamber ICDs were implanted in 168
(28%) patients, dual-chamber in 167 (28%) and biventricular in 269 (43%) patients.
ATP programming was activated in 546 (90%) patients. Overall survival and rate of
appropriate ICD intervention by ATP and/or shock at 12–24–36–48 months of follow-up were 94%, 89%, 80%, 75% and 16%, 28%, 37% and 50%, respectively.
No difference in mortality rate between the groups who received or did not receive
appropriate ICD interventions was demonstrated (p=ns).
Conclusions
The IRIDE study confirms the effectiveness in real world practice of ICD implantation
in patients at risk of SCD. The life saving role of ICD therapy increases as the duration
of follow-up is prolonged and the survival benefit is similar in patients who received
or did not receive appropriate device treatment, thus suggesting a beneficial effect
of up-to-date device programming.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to International Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators.N Engl J Med. 1999; 341: 1882-1890
- Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure.N Engl J Med. 2005; 352: 225-237
- Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure.N Engl J Med. 2004; 350: 2140-2150
- Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy.N Engl J Med. 2004; 350: 2151-2158
- Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators.N Engl J Med. 1996; 335: 1933-1940
- Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction.N Engl J Med. 2002; 346: 877-883
- Primary prevention of sudden cardiac death in idiopathic dilated cardiomyopathy: the Cardiomyopathy Trial (CAT).Circulation. 2002; 105: 1453-1458
- Cardiac-resynchronization therapy for the prevention of heart-failure events.N Engl J Med. 2009; 361: 1329-1338
- Effect of implantable defibrillators on arrhythmic events and mortality in the multicenter unsustained tachycardia trial.Circulation. 2002; 106: 233-238
- Implantable cardioverter defibrillators in primary and secondary prevention: a systematic review of randomized, controlled trials.Ann Intern Med. 2003; 138: 445-452
- Tracing the European course of cardiac resynchronization therapy from 2006 to 2008.Europace. 2010; 12: 692-701
- The 11th world survey of cardiac pacing and implantable cardioverter-defibrillators: calendar year 2009 — a World Society of Arrhythmia's project.Pacing Clin Electrophysiol. Aug. 34 2011; : 1013-1027
- The world survey of cardiac pacing and cardioverter-defibrillators: calendar year 2005 an International Cardiac Pacing and Electrophysiology Society (ICPES) project.Pacing Clin Electrophysiol. 2008; 31: 1202-1212
- Impact of the main implantable cardioverter-defibrillator trials in clinical practice: data from the Italian ICD Registry for the years 2005–07.Europace. 2009; 11: 465-475
- Clinical and arrhythmic outcomes after implantation of a defibrillator for primary prevention of sudden death in patients with post-myocardial infarction cardiomyopathy: the Survey to Evaluate Arrhythmia Rate in High-risk MI patients (SEARCH-MI).Europace. 2009; 11: 476-482
- Linee guida AIAC 2006 all'impianto di pacemaker, dispositivi per la resincronizzazione cardiaca (CRT) e defibrillatori automatici impiantabili (ICD).GIAC. 2005; 8: 1-58
- ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death) developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society.Europace. 2006; 8: 746-837
- Inappropriate implantable cardioverter-defibrillator shocks in MADIT II: frequency, mechanisms, predictors, and survival impact.J Am Coll Cardiol. 2008; 51: 1357-1365
- Prognostic importance of defibrillator shocks in patients with heart failure.N Engl J Med. 2008; 359: 1009-1017
- Appropriate and inappropriate ventricular therapies, quality of life, and mortality among primary and secondary prevention implantable cardioverter defibrillator patients: results from the Pacing Fast VT REduces Shock ThErapies (PainFREE Rx II) trial.Circulation. 2005; 111: 2898-2905
- Prospective randomized multicenter trial of empirical antitachycardia pacing versus shocks for spontaneous rapid ventricular tachycardia in patients with implantable cardioverter-defibrillators: Pacing Fast Ventricular Tachycardia Reduces Shock Therapies (PainFREE Rx II) trial results.Circulation. 2004; 110: 2591-2596
- Shock reduction using antitachycardia pacing for spontaneous rapid ventricular tachycardia in patients with coronary artery disease.Circulation. 2001; 104: 796-801
- Long-term benefit of primary prevention with an implantable cardioverter-defibrillator: an extended 8-year follow-up study of the Multicenter Automatic Defibrillator Implantation Trial II.Circulation. 2010; 122: 1265-1271
- Causes and consequences of heart failure after prophylactic implantation of a defibrillator in the multicenter automatic defibrillator implantation trial II.Circulation. 2006; 113: 2810-2817
- Endo-epicardial homogenization of the scar versus limited substrate ablation for the treatment of electrical storms in patients with ischemic cardiomyopathy.J Am Coll Cardiol. 2012; 60: 132-141
- Electrical storm in patients with transvenous implantable cardioverter-defibrillators: incidence, management and prognostic implications.J Am Coll Cardiol. 1998; 32: 1909-1915
- Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints.Stat Med. 1998; 17: 2815-2834
- Randomized trial of cardiac resynchronization in mildly symptomatic heart failure patients and in asymptomatic patients with left ventricular dysfunction and previous heart failure symptoms.J Am Coll Cardiol. 2008; 52: 1834-1843
- Detection of myocardial injury during transvenous implantation of automatic cardioverter-defibrillators.J Am Coll Cardiol. 1999; 34: 402-408
- A simplified biventricular defibrillator with fixed long detection intervals reduces implantable cardioverter defibrillator (ICD) interventions and heart failure hospitalizations in patients with non-ischaemic cardiomyopathy implanted for primary prevention: the RELEVANT [Role of long dEtection window programming in patients with LEft VentriculAr dysfunction, Non-ischemic eTiology in primary prevention treated with a biventricular ICD] study.Eur Heart J. 2009; 30: 2758-2767
- Programming antitachycardia pacing for primary prevention in patients with implantable cardioverter defibrillators: results from the PROVE trial.J Cardiovasc Electrophysiol. 2010; 21: 1349-1354
- Antiarrhythmic effect of reverse ventricular remodeling induced by cardiac resynchronization therapy: the InSync ICD (Implantable Cardioverter-Defibrillator) Italian Registry.J Am Coll Cardiol. 2008; 52: 1442-1449
- Expanding risk-profiling strategies for prediction and prevention of sudden cardiac death.J Am Coll Cardiol. 2010; 56: 215-217
- A critical appraisal of implantable cardioverter-defibrillator therapy for the prevention of sudden cardiac death.J Am Coll Cardiol. Sep. 30 2008; 52: 1111-1121
- Frequency and causes of implantable cardioverter-defibrillator therapies: is device therapy proarrhythmic?.Am J Cardiol. 2006; 97: 1255-1261
- Primary prevention implantable cardioverter defibrillator recipients: the need for defibrillator back-up after an event-free first battery service-life.J Cardiovasc Electrophysiol. December 2011; 22: 1346-1350
Article info
Publication history
Published online: March 14, 2013
Accepted:
December 12,
2012
Received in revised form:
December 10,
2012
Received:
June 5,
2012
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
