Primary and secondary prevention of sudden cardiac death in a hospital of the social security system in Costa Rica: report from the registry of patients with implantable cardioverter-defibrillators, 2007-2011

None; None

Abstracts

Aim: Several studies have demonstrated the efficacy of implantable cardioverter-defibrillators in the prevention of sudden cardiac death. The validation of this evidence has to be assessed through various registries. The objective of this study was to describe the main epidemiological and clinical characteristics of patients who were referred to a tertiary hospital in Costa Rica to be treated with a cardioverter-defibrillators implantable; as well as the associated problems and complications. Methods: A retrospective observational cohort study, which included all patients who were treated with a cardioverter-defibrillator implantable in the “Dr. Rafael A. Calderón Guardia” hospital between 2007 and 2011. Results: Twenty three patients were included. The mean age was 55 ± 18 years. Ischemic heart disease was the most frequent etiology (10 patients). Twenty patients had functional class I or II and the mean ejection fraction was 0.38 ± 0.17. In 18 patients, the cardioverter-defibrillator was implanted for secondary prevention. Five patients had an early complication; all of them had dual-chamber devices: 2 minor hematomas, 1 coronary sinus dissection, 1 right atrial lead displacement, and 1 cardio embolic stroke. From a total of 101 therapies (in 8 patients), 94 were appropriate (in 5 patients) and 7 were inappropriate (in 3 patients); 2 of the latter 3 patients had a history of atrial fibrillation episodes. Conclusion: This registry shows that the majority of implantable cardioverter-defibrillators implantations are performed as a secondary prevention, with a high rate of adequate therapies and a low rate of inadequate ones. The registry allowed an assessment of the indications and complications of this device therapy.

Implantable defibrillators; sudden death; arrhythmias

Justificación y objetivo: diversos estudios han demostrado la eficacia de los desfibriladores automáticos implantables en la prevención de la muerte súbita cardiaca. La aplicación de dicha evidencia debe ser evaluada mediante registros. El objetivo de este estudio fue describir las principales características epidemiológicas y clínicas y las complicaciones de los pacientes a quienes se les implanta un desfibrilador automático implantable en un hospital de tercer nivel en Costa Rica. Métodos: estudio observacional de cohorte, retrospectivo, que incluyó la totalidad de pacientes a quienes se les implantó un desfibrilador automático implantable en el hospital “Dr. Rafael Ángel Calderón Guardia” entre 2007 y 2011. Resultados: se incluyó 23 pacientes. La edad media fue de 55 ± 18 años. La cardiopatía isquémica fue la etiología más frecuente (10 pacientes). Veinte pacientes estaban en clase funcional I o II; la fracción de eyección media fue 0,38 ± 0,17. En los 18 pacientes el desfibrilador automático se implantó por prevención secundaria. Cinco pacientes presentaron una complicación temprana, todos ellos con dispositivos bicamerales: 2 hematomas menores, una disección del seno coronario, un desplazamiento del electrodo atrial derecho y un ictus cardioembólico. Hubo un total de 101 terapias (en 8 pacientes), de las cuales 94 fueron apropiadas (en 5 pacientes) y 7 inapropiadas (en 3 pacientes); dos de estos últimos habían tenido episodios previos de fibrilación atrial. Conclusión: este registro muestra que la mayoría de los implantes de desfibriladores automáticos se realizan por prevención secundaria, con una alta tasa de terapias adecuadas y una baja tasa de terapias inadecuadas y de complicaciones; además, permite evaluar las indicaciones y las complicaciones asociadas con esta terapia. este registro muestra que la mayoría de los implantes de desfibriladores automáticos se realizan por prevención secundaria, con una alta tasa de terapias adecuadas y una baja tasa de terapias inadecuadas y de complicaciones; además, permite evaluar las indicaciones y las complicaciones asociadas con esta terapia.

desfibriladores implantables; muerte súbita; arritmias; complicaciones

Aim: Several studies have demonstrated the efficacy of implantable cardioverter-defibrillators in the prevention of sudden cardiac death. The validation of this evidence has to be assessed through various registries. The objective of this study was to describe the main epidemiological and clinical characteristics of patients who were referred to a tertiary hospital in Costa Rica to be treated with a cardioverter-defibrillators implantable; as well as the associated problems and complications. Methods: A retrospective observational cohort study, which included all patients who were treated with a cardioverter-defibrillator implantable in the “Dr. Rafael A. Calderón Guardia” hospital between 2007 and 2011. Results: Twenty three patients were included. The mean age was 55 ± 18 years. Ischemic heart disease was the most frequent etiology (10 patients). Twenty patients had functional class I or II and the mean ejection fraction was 0.38 ± 0.17. In 18 patients, the cardioverter-defibrillator was implanted for secondary prevention. Five patients had an early complication; all of them had dual-chamber devices: 2 minor hematomas, 1 coronary sinus dissection, 1 right atrial lead displacement, and 1 cardio embolic stroke. From a total of 101 therapies (in 8 patients), 94 were appropriate (in 5 patients) and 7 were inappropriate (in 3 patients); 2 of the latter 3 patients had a history of atrial fibrillation episodes. Conclusion: This registry shows that the majority of implantable cardioverter-defibrillators implantations are performed as a secondary prevention, with a high rate of adequate therapies and a low rate of inadequate ones. The registry allowed an assessment of the indications and complications of this device therapy.This registry shows that the majority of implantable cardioverter-defibrillators implantations are performed as a secondary prevention, with a high rate of adequate therapies and a low rate of inadequate ones. The registry allowed an assessment of the indications and complications of this device therapy.

Implantable defibrillators; sudden death; arrhythmias

Costa Rica: report from the registry of patients with implantable cardioverter-defibrillators, 2007-2011

¹ Oswaldo Gutiérrez-Sotelo²

Cardiology Department, “Dr. Rafael Ángel Calderón Guardia” Hospital, San José, Costa Rica.

Author´s¹Cardiology and Cardiac Surgery Department, Universidad de Navarra (Universtiy of Navarra) Clinic.²Cardiology Department, CalderónGuardiaHospital. Universidad de Costa Rica (University of Costa Rica) and Universidad de Ciencias Médicas (University of Medical Sciences).

Abbreviatons: ICD,Implantable

Cardiac Defibrillator; AF, atrial fibrillation; EF, Left Ventricle Ejection Fraction; VF, ventricular fibrillation; SCD, Sudden Cardiac Death; NIDCM, non ischemic dilated cardiomyopathy. hugo.arguedas@hotmail.com

Background: Several studies have demonstrated the efficacy of implantable cardioverter defibrillators in the prevention of sudden cardiac death. The validation of this evidence has to be assessed through various registries. The objective of this study was to describe the main epidemiological and clinical characteristics of patients who were referred to a tertiary hospital in Costa Rica to be treated with a cardioverter-defibrillators implantable; as well as the associated problems and complications.

Methods: A retrospective observational cohort study, which included all patients who were treated with a cardioverter-defibrillator implantable in the “Dr. Rafael A. Calderón Guardia” hospital between 2007 and 2011.

Results: Twenty three patients were included. The mean age was 55 ± 18 years. Ischemic heart disease was the most frequent etiology (10 patients). Twenty patients had functional class I or II and the mean ejection fraction was 0.38 ± 0.17. In 18 patients, the cardioverter-defibrillator was implanted for secondary prevention. Five patients had an early complication; all of them had dual-chamber devices: 2 minor hematomas, 1 coronary sinus dissection, 1 right atrial lead displacement, and 1 cardio embolic stroke. From a total of 101 therapies (in 8 patients), 94 were appropriate (in 5 patients) and 7 were inappropriate (in 3 patients); 2 of the latter 3 patients had a history of atrial fibrillation episodes.

Conclusion: This registry shows that the majority of implantable cardioverter-defibrillators implantations are performed as a secondary prevention, with a high rate of adequate therapies and a low rate of inadequate ones. The registry allowed an assessment of the indications and complications of this device therapy.

Key words: Implantable defibrillators, sudden death, arrhythmias.

^1-5The risk of death from someone who has had an aborted SCD is nearly 95%; half the survivors will be readmitted within one year and 40% will die within the next 2 years.^2-4SCD risk increases exponentially when the ejection fraction (EF) is less than 0,3.³Functional class also proved to be an independent risk predictor for SCD,^4,5especially in patients with functional class IV, but it only represents one third of such deaths, since the remaining two thirds occur in patients with compensated heart failure symptoms and a functional class II. ^{6, 7}Identification of populations at risk for SCD had little effect in reducing the cumulative incidence, as it mostly occurs in people without identifiable risk factors, namely “healthy” population.

⁸^-10and its superiority against drug treatment. Secondary prevention is defined as those measures applied after an episode of aborted SCD or an episode of sustained ventricular tachycardia (VT), with or without hemodynamic involvement. Primary prevention regards to those measures taken without occurring any such events. International consensus management guidelines have been established ⁹and consequently, there has been an increase in the overall number of implants, therefore the evidence applied to the particular situation in each population center must be evaluated. The only way to achieve this is by conducting surveys and records to compare results with other centers and meet the populations who receive ICD´s. ^10-14The aim of this study was to describe the main epidemiological and clinical characteristics at the time of implantation, as well as knowing the immediate and late complications of the population with an ICD, both for primary and secondary prevention, at a third level hospital in Costa Rica.

San José, Costa Rica. The first ICD implanted at the Cardiology Service was made in 1999, but the implant rate was very low until 2 years ago, when an Electrophysiology program was started. The study was authorized by the Hospital´s Ethics-Scientific Committee, and was not sponsored nor was included in any other study.

Figure 1. Therapy was considered appropriate when the device detected properly an episode of ventricular arrhythmia and administered one programmed therapy, while inappropriate therapy was that which made an inadequate discrimination of an episode of supraventricular arrhythmia, or over-sensing extracardiac signals as myopotentials, or electromagnetic interference. “Electrical storm”, defined as the occurrence of three or more episodes of sustained VT or VF, within a 24 hour period, each separated from the previous one, at least 5 minutes of ventricular arrhythmia-free interval. Early complication was defined as that which occurred in the first 30 days of device implantation, and late complications were those which occurred after that period. A minor complication was that one which did not require a new intervention, hospitalization, or imply a risk to the patient’s life.

Figure 1

Table 1).

Thumbnail

Table 1

Underlying cardiopathy, ejection fraction, functional class and basal rhythms.

Figure 2). Most patients were in functional class I or II at the time of implantation (20 patients). Only 2 patients were in functional class III and one was in class IV. Most of the population had moderate or severe impairment of the FE, with a mean of 0.38 ± 0.17, and in about one third of the population was <0.25. At the time of implantation, 17 patients were in sinus rhythm and five in atrial fibrillation (AF). Nine patients had a previous event of FA. Five patients had left bundle branch block bundle, 3 right bundle branch, 2 had a first-degree atrioventricular block and 1 had Sick Sinus Node Syndrome.

Figure 2

Figure 2).

Table 1). Fifteen secondary prevention patients were medicated with amiodarone, while only one primary prevention patient used it.

Table 2).

Thumbnail

Table 2

Table 3).

Thumbnail

Table 3

Figure 3).

Figure 3

Figure 4). Five patients had an “electrical storm”; they were four secondary prevention patients: 3 with ischemic heart disease and 1 with NIDCM. These 4 patients haven´t recurred, after receiving adjustment of antiarrhythmic medication and reprogramming therapy zones with an antitachycardia pacemaker. The last storm case was a man with NIDCM, functional class IV and FE = 0.15, to whom an ICD with resynchronization therapy was implanted, as a rescue option for his advanced disease. He developed recurrent VT and VF, and received appropriate ICD therapies; however, he died three days later because of terminal heart failure and electromechanical dissociation.

Figure 4

¹¹Although the average age appears to be lower in this study compared to other reports, its variation was in the previously reported ranges.^{12, 13}Underlying heart disease was also distributed similarly, and ischemic heart disease was the most common, followed by NIDCM. ¹⁴Despite the high frequency of chagasic myocarditis in Latin America, ¹⁵there were no cases in this series.

¹⁶Only two patients underwent electrophysiological studies for induction of ventricular arrhythmias; this allows upgrading to class I recommendation in selected patients. The average EF in this study is similar to that published in secondary prevention studies, there was a lower EF in the primary prevention group, as expected, due to the different indications for implantation, although this wasn´t a significant difference compared to the secondary prevention group.¹⁷Usefulness of amiodarone in secondary prevention patients has been described, as a measure to prevent and reduce the number of therapies provided by the device, or to make them more tolerable by decreasing VT frequency and allowing the antitachycardia algorithms to function. In this series, this drug was also more frequently used in this subgroup; a primary prevention patient taking the drug, even when it has been shown that it doesn´t provide greater benefit in this group, compared with the ICD.¹⁸

¹⁹In this series, 2 out of 3 patients who received inappropriate therapies, had FA.

²⁰They all occurred in patients with dual-chamber devices. Only one patient had a clear indication for an anti-bradycardia pacemaker because of Sick Sinus Syndrome. Another 5 patients with left bundle branch block would have been candidates for tricameral device implantation. The majority of patients included in the ICD efficacy studies received an unicameral device, subsequent reports have shown a trend towards the introduction of dual-chamber devices, but the theoretical advantage of such models hasn´t shown a clear superiority over unicameral models; ²¹besides, the placement of an additional number of electrodes significantly increases the complication rate.²²It should be noted that the group of patients receiving a dual chamber ICD had a higher proportion of morbidities and may include some patients that had unsuccessful attempts to put a left ventricular lead. Tricameral ICD implantation increases the risk of complications such as hematomas, electrode displacement, coronary sinus dissection and cardiovascular death, ²³especially if they are taking anticoagulants or antiplatelet therapy concomitantly. Of course, any complication increases stay and hence hospitalization costs.²⁴

^25-27and affect up to 15% of patients who received an ICD, ^26-27which coincides with the number of inapproppriate events in this study. Most had previous episodes of AF and the shock was triggered by a misdiagnosed supra-ventricular tachycardia. Receiving inappropriate shocks lead to higher recurrence and mortality rates, so the use of more advanced algorithms and improved programming should reduce them, ²⁵multicenter randomizedstudiesarebeingmadeforthatpurpose.“Electrical storm” has an incidence between 7, 10 and up to 25% per year, ²⁶as applicable to populations with tri, uni-or bicameral, devices respectively, but also influenced by the different populations that receive uni or bicameral ICD´s. These are mainly in patients with sustained ventricular arrhythmias or high risk of SCD, compared to those in which a cardiac resynchronization capable ICD is implanted, in which heart failure prevails. The series showed, agreeing with previous studies, increased risk of electrical storm in secondary prevention patients; however, most of these patients had an ischemic background, in contrast with the fact that NIDCM patients have a greater risk according to other reports.²⁷Most of these patients were managed optimizing medical treatment and reprogramming therapy modalities; the combined use of beta-blockers and amiodarone has shown to significantly reduce the risk of shocks.²⁸

Costa Rica; this also was a retrospective analysis. Most ICD´s came from a single brand; in the future there will be more information about other brands and their clinical results, as the use of ICDs in primary prevention will become larger.

Costa Rica. Such a record provides valuable information for term standardization prior to ICD implantation, as well as standardizing the indications for which it should be placed in both primary and secondary prevention; besides, it improves the panorama for future decisions about using the most appropriate device, depending on the patient´s characteristics, and allow monitoring the trend of ICD implants, as well as the frequency of complications, and reevaluating if routine use of dual chamber ICDs is indicated in patients without a clear indication for a pacemaker or resynchronization therapy.

Conflict of interest: The authors have received financial and logistical support of the brand representatives Saint Jude Medical and Medtronic, for academic activities organized by independent institutions.

Acknowledgment: The authors thank engineer Grace Vargas, product specialist of SUMEDICAL Costa Rica, for her help in finding and organizing track records of their patients.

References

1. Elliott PM, Poloniecki J, Dickie S, et al. Sudden death in hypertrophic cardiomyopathy: identification of high risk patients. J Am Coll Cardiol2000; 36: 2212–8.
2. Kuller L, Lilienfeld A, Fisher R. An epidemiological study of sudden and unexpected deaths in adults. Medicine (Baltimore) 1967; 46:341-361.
3. Huikuri HV, Castellanos A, Myerburg RJ. Sudden death due to cardiac arrhythmias. N EnglJ Med 2001; 345: 1473–82.
4. The MERIT-HF Investigators. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet 1999; 353: 2001–7.
5. The Multicentre Postinfarction Research Group. Risk stratification and survival after myocardial infarction. N EnglJ Med 1983; 309: 331– 6.
6. Bigger JT Jr., Fleiss JL, Kleiger R, Miller JP, Rolnitzky LM. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation 1984; 69:250–8.
7. Luu M, Stevenson WG, Stevenson LW, Baron K, Walden J. Diverse mechanisms of unexpected cardiac arrest in advanced heart failure. Circulation 1989; 80:1675–80.
8. The antiarrhythmics versus implantable defibrillator (AVID) investigators. A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N EnglJ Med 1997; 337: 1576-1583.
9. Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). Circulation. 2008; 117:2820–2840.
10. Hammill SC, Berul C, Kremers MS, Kadish AH, Stevenson LW, Heidenreich PA, et al. Review of the ICD Registry’s Third Year, Expansion to include Lead Data and Pediatric ICD Procedures, and Role for Measuring Performance. Heart Rhythm(2009); 6: 1397-1401.
11. Di toro D, Boracci RA, Rubio M, Serra J. Estimación del número de marcapasos y cardiodesfibriladores implantados anualmente en Argentina. Rev Argent Cirugía. 2009; 97: 85-90.
12. Proclemer A, Ghidina M, Cicuttini G, Gregori D, Fioretti PM: Impact of the Main Implantable Cardioverter-Defibrillator Trials for Primary and Secondary Prevention in Italy: A Survey of the National Activity During the Years 2001–2004. PACE 2006; 29 (Suppl 2): S20-S28.
13. Dubner S, Valero E, Pesce R, Zuelgaray JG, Mateos JC, Filho SG, Reyes W et al. A Latin American registry of implantable cardioverter de- fibrillators: the ICD-LABOR study. Ann Noninvasive Electrocardiol. 2005; 10: 420-8.
14. Connolly SJ, Hallstrom AP, Cappato R, et al. Meta-analysis of the implantable cardioverter defibrillator secondary prevention trials. AVID, CASH and CIDS studies. Antiarrhythmics vs Implantable Defibrillator study. Cardiac Arrest Study Hamburg. Canadian Implantable Defibrillator Study. EurHeart J. 2000; 21: 2071– 8.
15. Gutiérrez O, Garita E, Salazar E. Thoracoscopic Sympathectomy For Incessant Polymorphic Ventricular Tachycardia In Chronic Chagasic Myocarditis. A Case Report. Int J Cardiol 2007 Jul 10;119: 255-7.
16. Epstein AE, DiMarco JP, Ellenbogen KA, Mark Estes NA, Freedman RA , Gettes LS et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation 2008; 117; 350-408.
17. Myerburg RJ, Reddy V, Castellanos A. Indications for implantable cardioverter- defibrillators based on evidence and judgment. J Am Coll Cardiol. 2009; Vol. 54: 747–63.
18. Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineu R, Domanski M, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med2005; 352: 225-237.
19. Borleffs CJW, van Rees JB, van Welsenes GH, van der Velde ET, van Erven L, Bax JJ, et al. Prognostic Importance of Atrial Fibrillation in Implantable Cardioverter-Defibrillator Patients. J Am Coll Cardiol 2010;55:879–85.
20. Van Rees JB, de Bie MK, Thijssen J, Borleffs CJ, Schalij MJ, van Erven L. Implantation-Related Complications of Implantable Cardioverter-Defibrillators and Cardiac Resynchronization Therapy Devices. A Systematic Review of Randomized Clinical Trials. J Am Coll Cardiol2011; 58:995–1000.
21. Theuns DA, Klootwijk AP, Goedhart DM, Jordaens LJ. Prevention of Inappropriate Therapy in Implantable Cardioverter-Defibrillators: Results of a Prospective, Randomized Study of Tachyarrhythmia Detection Algorithms. J Am Coll Cardiol 2004;44:2362–7.
22. Lee DS, Krahn AD, Healey JS, Birnie D, Crystal E, Dorian P, et al for the Investigators of the Ontario ICD Database. Evaluation of Early Complications Related to De Novo Cardioverter Defibrillator Implantation Insights From the Ontario ICD Database. J Am Coll Cardiol2010; 55:774–82.
23. Dewland TA, Pellegrini CN, Wang Y, Marcus GM, Keung E, Varosy PD. Dual-Chamber Implantable Cardioverter-Defibrillator Selection Is Associated With Increased Complication Rates and Mortality Among Patients Enrolled in the NCDR Implantable Cardioverter-Defibrillator Registry. J Am Coll Cardiol2011; 58:1007–13.
24. Reynolds MR, Cohen DJ, Kugelmass AD, Brown PP, Becker ER, Culler SD, et al. The Frequency and Incremental Cost of Major Complications Among Medicare Beneficiaries Receiving Implantable Cardioverter-Defibrillators. J Am Coll Cardiol2006; 47:2493–7.
25. Van Rees JB, Willem Borleffs CJ, de Bie MK, Stijnen T, van Erven L, Bax JJ, Schalij MJ. Inappropriate Implantable Cardioverter-Defibrillator Shocks: Incidence, Predictors and Impact on Mortality. J Am Coll Cardiol2011;57:556–62.
26. Hohnloser SH, Al-Khalidi HR, Pratt CM, et al. Electrical storm in patients with implantable defibrillator: incidence, features, and preventive therapy: insights from a randomized trial. EurHeart J 2006; 27:3027-32.
27. Gasparini M, Lunati M, Landolina M, Santini M, Padeletti L, Perego G, et al on behalf of the InSync ICD Italian Registry Investigators. Electrical storm in patients with biventricular implantable cardioverter defibrillator: Incidence, predictors, and prognostic implications. Am HeartJ 2008; 156:847-54.
28. Connolly SJ, Dorian P, Roberts RS, et al. Comparison of b-blockers, amiodarone plus b-blockers, or sotalol for prevention of shocks from implantable cardioverter defibrillators. The OPTIC study: a randomized trial. JAMA 2006; 295:165-71.

en_bart08v55n1

Received Date: March 12^th, 2012 Accepted Date: October 25^th, 2012

References

1. Elliott PM, Poloniecki J, Dickie S, et al. Sudden death in hypertrophic cardiomyopathy: identification of high risk patients. J Am Coll Cardiol2000; 36: 2212–8.
2. Kuller L, Lilienfeld A, Fisher R. An epidemiological study of sudden and unexpected deaths in adults. Medicine (Baltimore) 1967; 46:341-361.
3. Huikuri HV, Castellanos A, Myerburg RJ. Sudden death due to cardiac arrhythmias. N EnglJ Med 2001; 345: 1473–82.
4. The MERIT-HF Investigators. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet 1999; 353: 2001–7.
5. The Multicentre Postinfarction Research Group. Risk stratification and survival after myocardial infarction. N EnglJ Med 1983; 309: 331– 6.
6. Bigger JT Jr., Fleiss JL, Kleiger R, Miller JP, Rolnitzky LM. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation 1984; 69:250–8.
7. Luu M, Stevenson WG, Stevenson LW, Baron K, Walden J. Diverse mechanisms of unexpected cardiac arrest in advanced heart failure. Circulation 1989; 80:1675–80.
8. The antiarrhythmics versus implantable defibrillator (AVID) investigators. A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N EnglJ Med 1997; 337: 1576-1583.
9. Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). Circulation. 2008; 117:2820–2840.
10. Hammill SC, Berul C, Kremers MS, Kadish AH, Stevenson LW, Heidenreich PA, et al. Review of the ICD Registry’s Third Year, Expansion to include Lead Data and Pediatric ICD Procedures, and Role for Measuring Performance. Heart Rhythm(2009); 6: 1397-1401.
11. Di toro D, Boracci RA, Rubio M, Serra J. Estimación del número de marcapasos y cardiodesfibriladores implantados anualmente en Argentina. Rev Argent Cirugía. 2009; 97: 85-90.
12. Proclemer A, Ghidina M, Cicuttini G, Gregori D, Fioretti PM: Impact of the Main Implantable Cardioverter-Defibrillator Trials for Primary and Secondary Prevention in Italy: A Survey of the National Activity During the Years 2001–2004. PACE 2006; 29 (Suppl 2): S20-S28.
13. Dubner S, Valero E, Pesce R, Zuelgaray JG, Mateos JC, Filho SG, Reyes W et al. A Latin American registry of implantable cardioverter de- fibrillators: the ICD-LABOR study. Ann Noninvasive Electrocardiol. 2005; 10: 420-8.
14. Connolly SJ, Hallstrom AP, Cappato R, et al. Meta-analysis of the implantable cardioverter defibrillator secondary prevention trials. AVID, CASH and CIDS studies. Antiarrhythmics vs Implantable Defibrillator study. Cardiac Arrest Study Hamburg. Canadian Implantable Defibrillator Study. EurHeart J. 2000; 21: 2071– 8.
15. Gutiérrez O, Garita E, Salazar E. Thoracoscopic Sympathectomy For Incessant Polymorphic Ventricular Tachycardia In Chronic Chagasic Myocarditis. A Case Report. Int J Cardiol 2007 Jul 10;119: 255-7.
16. Epstein AE, DiMarco JP, Ellenbogen KA, Mark Estes NA, Freedman RA , Gettes LS et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation 2008; 117; 350-408.
17. Myerburg RJ, Reddy V, Castellanos A. Indications for implantable cardioverter- defibrillators based on evidence and judgment. J Am Coll Cardiol. 2009; Vol. 54: 747–63.
18. Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineu R, Domanski M, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med2005; 352: 225-237.
19. Borleffs CJW, van Rees JB, van Welsenes GH, van der Velde ET, van Erven L, Bax JJ, et al. Prognostic Importance of Atrial Fibrillation in Implantable Cardioverter-Defibrillator Patients. J Am Coll Cardiol 2010;55:879–85.
20. Van Rees JB, de Bie MK, Thijssen J, Borleffs CJ, Schalij MJ, van Erven L. Implantation-Related Complications of Implantable Cardioverter-Defibrillators and Cardiac Resynchronization Therapy Devices. A Systematic Review of Randomized Clinical Trials. J Am Coll Cardiol2011; 58:995–1000.
21. Theuns DA, Klootwijk AP, Goedhart DM, Jordaens LJ. Prevention of Inappropriate Therapy in Implantable Cardioverter-Defibrillators: Results of a Prospective, Randomized Study of Tachyarrhythmia Detection Algorithms. J Am Coll Cardiol 2004;44:2362–7.
22. Lee DS, Krahn AD, Healey JS, Birnie D, Crystal E, Dorian P, et al for the Investigators of the Ontario ICD Database. Evaluation of Early Complications Related to De Novo Cardioverter Defibrillator Implantation Insights From the Ontario ICD Database. J Am Coll Cardiol2010; 55:774–82.
23. Dewland TA, Pellegrini CN, Wang Y, Marcus GM, Keung E, Varosy PD. Dual-Chamber Implantable Cardioverter-Defibrillator Selection Is Associated With Increased Complication Rates and Mortality Among Patients Enrolled in the NCDR Implantable Cardioverter-Defibrillator Registry. J Am Coll Cardiol2011; 58:1007–13.
24. Reynolds MR, Cohen DJ, Kugelmass AD, Brown PP, Becker ER, Culler SD, et al. The Frequency and Incremental Cost of Major Complications Among Medicare Beneficiaries Receiving Implantable Cardioverter-Defibrillators. J Am Coll Cardiol2006; 47:2493–7.
25. Van Rees JB, Willem Borleffs CJ, de Bie MK, Stijnen T, van Erven L, Bax JJ, Schalij MJ. Inappropriate Implantable Cardioverter-Defibrillator Shocks: Incidence, Predictors and Impact on Mortality. J Am Coll Cardiol2011;57:556–62.
26. Hohnloser SH, Al-Khalidi HR, Pratt CM, et al. Electrical storm in patients with implantable defibrillator: incidence, features, and preventive therapy: insights from a randomized trial. EurHeart J 2006; 27:3027-32.
27. Gasparini M, Lunati M, Landolina M, Santini M, Padeletti L, Perego G, et al on behalf of the InSync ICD Italian Registry Investigators. Electrical storm in patients with biventricular implantable cardioverter defibrillator: Incidence, predictors, and prognostic implications. Am HeartJ 2008; 156:847-54.
28. Connolly SJ, Dorian P, Roberts RS, et al. Comparison of b-blockers, amiodarone plus b-blockers, or sotalol for prevention of shocks from implantable cardioverter defibrillators. The OPTIC study: a randomized trial. JAMA 2006; 295:165-71.

en_bart08v55n1

Received Date: March 12^th, 2012 Accepted Date: October 25^th, 2012

Publication Dates

Publication in this collection
01 Aug 2013
Date of issue
Mar 2013

History

Received
12 Mar 2012
Accepted
25 Oct 2012

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[24] 24. Reynolds MR, Cohen DJ, Kugelmass AD, Brown PP, Becker ER, Culler SD, et al. The Frequency and Incremental Cost of Major Complications Among Medicare Beneficiaries Receiving Implantable Cardioverter-Defibrillators. J Am Coll Cardiol2006; 47:2493–7.

[25] 25. Van Rees JB, Willem Borleffs CJ, de Bie MK, Stijnen T, van Erven L, Bax JJ, Schalij MJ. Inappropriate Implantable Cardioverter-Defibrillator Shocks: Incidence, Predictors and Impact on Mortality. J Am Coll Cardiol2011;57:556–62.

[26] 26. Hohnloser SH, Al-Khalidi HR, Pratt CM, et al. Electrical storm in patients with implantable defibrillator: incidence, features, and preventive therapy: insights from a randomized trial. EurHeart J 2006; 27:3027-32.

[27] 27. Gasparini M, Lunati M, Landolina M, Santini M, Padeletti L, Perego G, et al on behalf of the InSync ICD Italian Registry Investigators. Electrical storm in patients with biventricular implantable cardioverter defibrillator: Incidence, predictors, and prognostic implications. Am HeartJ 2008; 156:847-54.

[28] 28. Connolly SJ, Dorian P, Roberts RS, et al. Comparison of b-blockers, amiodarone plus b-blockers, or sotalol for prevention of shocks from implantable cardioverter defibrillators. The OPTIC study: a randomized trial. JAMA 2006; 295:165-71.

<b>Primary and secondary prevention of sudden cardiac death in a hospital of the social security system in Costa Rica</b>: <b>report from the registry of patients with implantable cardioverter-defibrillators, 2007-2011</b>

Abstracts

References

References

Publication Dates

History