Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe.
Eur Heart J
; 45(7): 538-548, 2024 Feb 16.
Article
in En
| MEDLINE
| ID: mdl-38195003
ABSTRACT
BACKGROUND AND AIMS:
Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death (SCD) in arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to identify cross-continental differences in utilization of primary prevention ICDs and survival free from sustained ventricular arrhythmia (VA) in ARVC.METHODS:
This was a retrospective analysis of ARVC patients without prior VA enrolled in clinical registries from 11 countries throughout Europe and North America. Patients were classified according to whether they received treatment in North America or Europe and were further stratified by baseline predicted VA risk into low- (<10%/5 years), intermediate- (10%-25%/5 years), and high-risk (>25%/5 years) groups. Differences in ICD implantation and survival free from sustained VA events (including appropriate ICD therapy) were assessed.RESULTS:
One thousand ninety-eight patients were followed for a median of 5.1 years; 554 (50.5%) received a primary prevention ICD, and 286 (26.0%) experienced a first VA event. After adjusting for baseline risk factors, North Americans were more than three times as likely to receive ICDs {hazard ratio (HR) 3.1 [95% confidence interval (CI) 2.5, 3.8]} but had only mildly increased risk for incident sustained VA [HR 1.4 (95% CI 1.1, 1.8)]. North Americans without ICDs were at higher risk for incident sustained VA [HR 2.1 (95% CI 1.3, 3.4)] than Europeans.CONCLUSIONS:
North American ARVC patients were substantially more likely than Europeans to receive primary prevention ICDs across all arrhythmic risk strata. A lower rate of ICD implantation in Europe was not associated with a higher rate of VA events in those without ICDs.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Defibrillators, Implantable
/
Arrhythmogenic Right Ventricular Dysplasia
Type of study:
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Country/Region as subject:
America do norte
/
Europa
Language:
En
Journal:
Eur Heart J
Year:
2024
Document type:
Article
Affiliation country:
Estados Unidos