Author + information
- Edlira Yzeiraj,
- Amr F. Barakat,
- Paul Cremer and
- Wael Jaber
Background: In patients with a left ventricular ejection fraction (LVEF) ≤ 35%, randomized clinical trials have demonstrated the benefit of implantable cardioverter defibrillators (ICDs) in the primary prevention of sudden cardiac death. However, the modality for LVEF assessment was not mandated, and variability in LVEF assessment could lead to different recommendations regarding ICDs. Our aim was to evaluate the discrepancy between radionuclide multigated acquisition (MUGA) scan and echocardiography in LVEF assessment and its implications for primary prevention ICD.
Methods: All consecutive patients who had both a MUGA scan and an ECHO within 30 days at our institution between Jan 2011 and Dec 2015 were included. We excluded patients who received cardiotoxic medications or had a medication change between the two studies.
Results: In 91 patients, the mean age was 62 ± 13 years, most were male (60%), and the median interval between the 2 studies was 7 days. The mean LVEF by MUGA was 53 ± 14% and was 45 ± 14% by echocardiography. Upon comparison, the mean difference in the means was 7%. When primary prevention ICD would be indicated by either of the 2 modalities, discordance was more common than concordance (17 vs. 7 patients, Fig 1A). Much of the discordance was related to patients with mildly or moderately reduced LVEF (Fig 1B).
Conclusions: In patients with mildly or moderately reduced LVEF, the modality of LVEF assessment could alter the recommendation for a primary prevention ICD as mandated by current guidelines.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias and Clinical EP: Devices 3
Abstract Category: 5. Arrhythmias and Clinical EP: Devices
Presentation Number: 1188-077
- 2017 American College of Cardiology Foundation