Posted on 05/01/2012

Patients with implantable defibrillators (ICDs) or resynchronization devices with defibrillator (CRT-Ds) were most likely to die of heart failure or noncardiac causes, not sudden death, a single-center study found.

Of the 2,859 patients included in the analysis, the 8-year cumulative incidence for heart failure death was 8.6% among patients with an ICD for primary prevention and 9.6% among secondary prevention ICD patients, and 22.6% for those with a CRT-D (log rankP<0.001), reported Martin J. Schalij, MD, PhD, and colleagues from Leiden University Medical Center in Leiden, The Netherlands.

Conversely, the 8-year cumulative incidence of sudden death was 2.1% and 3.2% in the primary and secondary prevention ICD patients, and 3.6% in those with a CRT-D (log rank P=0.026), according to the study published online in the journal HeartRhythm.

Defibrillator devices have been shown in large randomized trials to decrease mortality among primary prevention ICD patients, including those with ischemic and nonischemic heart disease at risk of sudden arrhythmic death.

They also have been shown to have a mortality benefit in secondary prevention, including those who have survived life-threatening ventricular arrhythmias.

Currently, many heart failure patients receive CRT-D devices because the addition of defibrillation has been shown to confer a mortality benefit, researchers said.


SOURCE: MedPage Today