Distinct Clinical Features in the Recipients of the Implantable Cardioverter Defibrillator in Taiwan: A Multicenter Registry Study
Journal
PACE - Pacing and Clinical Electrophysiology
Journal Volume
26
Journal Issue
11
Pages
2083-2090
Date Issued
2003
Author(s)
Abstract
Little information about the ICD is available from the Asian Pacific region. The purpose of this study was to characterize the clinical features in ICD patients in Taiwan and to compare these features with those in patients in the Western populations, mainly the Canadian Implantable Defibrillator Study (CIDS), the Antiarrhythmics versus Implantable Defibrillator (AVID) trial, and the Cardiac Arrest Study Hamburg (CASH) trial. From February 1995 to October 2001, 101 ICDs were implanted in 92 patients (78 [84%] men) in 12 hospitals. Clinical presentations included sudden cardiac death due to VF/VT in 35 (38%) patients, syncopal VT in 25 (27%), drug refractory nonsyncopal VT in 27 (29%), and unexplained syncope with inducible sustained VT/VF in 5 (6%). The mean age was significantly younger than that in CIDS or AVID (59 ± 16 vs 63 ± 9 years in CIDS, P = 0.02; vs 65 ± 11 years in AVID, P < 0.001), but was comparable to that in CASH (59 ± 16 vs 58 ± 11 years in CASH, P = 0.75). The mean LVEF was significantly higher than that in CIDS or AVID (48 ± 19% vs 34 ± 15% in CIDS, P < 0.002; vs 32 ± 13% in AVID, P < 0.001), but was comparable to that in CASH (48 ± 19 vs 46 ± 19% in CIDS, P = 0.83). The ICD patients in the current study also showed a higher incidence of normal heart (23 vs 4% in CIDS, P < 0.001; vs 3% in AVID, P < 0.001; vs 9% in CASH, P < 0.001) and cardiomyopathy (41 % vs 10% in CIDS, P < 0.001; vs 15% in AVID, P < 0. 001; vs 11% in CASH, P < 0.001), but a lower incidence of coronary artery disease (29% vs 83% in CIDS, P < 0.001; vs 82% in AVID, P < 0.001; vs 73% in CASH, P < 0.001). During a mean follow-up of 28 ± 24 months, 13 (14%) patients died. Older age was the only factor associated with poorer survival after ICD implantation. Forty-seven (51%) patients received appropriate ICD discharges during follow-up. History of prior myocardial infarction was the only factor associated with an earlier first appropriate ICD discharge and LVEF < 0.35 the only factor associated with subsequent poorer survival after the first ICD discharge. In conclusion, this study demonstrated many distinct clinical features in our ICD population that were different from those in the Western populations.
SDGs
Other Subjects
adult; aged; article; cardiomyopathy; controlled study; defibrillator; female; follow up; heart death; heart muscle refractory period; heart ventricle fibrillation; heart ventricle tachycardia; hospital; human; intermethod comparison; ischemic heart disease; major clinical study; male; mortality; population research; recipient; risk factor; statistical analysis; survival; survival rate; syncope; Taiwan; treatment outcome; Aged; Chi-Square Distribution; Death, Sudden, Cardiac; Defibrillators, Implantable; Female; Humans; Male; Middle Aged; Proportional Hazards Models; Randomized Controlled Trials; Registries; Survival Analysis; Tachycardia, Ventricular; Taiwan; Treatment Outcome; Ventricular Fibrillation
Type
journal article