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CorSalud
versión On-line ISSN 2078-7170
Resumen
CRUZ CARDENTEY, Marleny et al. Follow-up of the patient with automatic implantable cardioverter-defibrillator. CorSalud [online]. 2020, vol.12, n.3, pp. 283-291. Epub 01-Sep-2020. ISSN 2078-7170.
Introduction:
Implantable cardioverter-defibrillators improve the survival of patients at risk of sudden cardiac death. There is relatively little data in our country about their follow-up effectiveness.
Objective:
To describe the outcome of patients with primo-implantation of an automatic cardioverter-defibrillator during follow-up.
Methods:
An ambispective longitudinal cohort study was conducted in 47 patients with primo-implantation of a cardioverter-defibrillator in the period September 2007 to December 2016, ending on December 31, 2017. The cumulative probability of survival was estimated through the Kaplan-Meier curves.
Results:
Mean age was 57 ± 14.6 years, with male predominance (74.5%) and indication in secondary prevention (83%). Adequate therapies were found in 57.4% of patients, inadequate therapies in 23.4%, implantable cardioverter-defibrillator proarrhythmia in 14.9% and arrhythmic storm in 12.8% of patients. Adequate therapies were related to an ejection fraction ≤ 35% (p=0.022) and age (p=0.031). Cumulative free survival from the first event at four years was 34,7%. Cardiovascular mortality was related to: existence of structural heart disease (p=0.044), ejection fraction ≤ 35% (p<0.001), functional class III-IV (p=0.046), adequate therapies (p=0.014) and arrhythmic storm (p=0.002). Cumulative free survival of cardiovascular mortality was 70.7% at the fourth year.
Conclusions:
The survival of patients with implantable cardioverter-defibrillator is satisfactory. Mortality is associated with further deterioration of cardiovascular status and with device therapies.
Palabras clave : Implantable cardioverter-defibrillator; Sudden cardiac death; Sudden arrhythmic death; Proarrhythmia.