Author + information
- Received May 27, 1992
- Revision received December 2, 1992
- Accepted December 7, 1992
- Published online June 1, 1993.
- Dirk Böcker, MD∗,
- Michael Block, MD,
- Frank Isbruch, MD,
- Dietmar Wietholt, MD,
- Dieter Hammel, MD,
- Martin Borggrefe, MD and
- Günter Breithardt, MD, FACC
- ↵∗Address for correspondence: Dirk Böcker, MD, University Hospital, Department of Cardiology, Albert-Schweitzer-Str. 33, D-4400 Münster, Germany.
Objectives. This study was done to provide information on the potential benefit of implantable cardioverter-defibrillator therapy regarding sudden and arrhythmia-related deaths and to examine whether such therapy improves survival.
Background. Implantation of automatic cardioverter-defibrillators is reported to abort sudden cardiac death due to malignant tachyarrhythmias.
Methods. Between 1989 and 1992, 107 patients were screened for implantation of a third-generation implantable cardioverter-defibrillator combined with endocardial leads. Mean age was 57 ± 13 years and mean ejection fraction was 40 ± 15%. Sudden death, total arrhythmia-related death and total cardiac death were compared with the occurrence of fast ventricular tachyarrhythmias (>240 beats/min), assuming that most of these arrhythmias would have been fatal without treatment by the implantable cardioverter-defibrillator.
Results. The surgical mortality rate was 2.7% in all 107 patients and 1% in the 99 patients who qualified for endocardial leads. During a follow-up period of 12 ± 8 months, actuarial survival rate free of events at 6 months as well as at 12 and 18 months was 100% for sudden death, 97% for total arrhythmiarelated death and 95% for total cardiac death. In contrast, after 6, 12 and 18 months, the rate of survival free of fast ventricular tachycardia was only 83%, 74% and 69%, respectively, and the rate of survival free of any ventricular tachyarrhythmia was only 59%, 49% and 40%, respectively.
Conclusions. The outcome of patients treated with an implantable cardioverter-defibrillator and endocardial defibrillation leads is excellent. For many patients, this treatment is probably lifesaving.
- Received May 27, 1992.
- Revision received December 2, 1992.
- Accepted December 7, 1992.