Cardioverter-defibrillators in hypertrophic cardiomyopathy : a French multicenter study - Université de Lorraine Access content directly
Master Thesis Year : 2016

Les défribilateurs automatiques dans les cardiomyopathies hypertrophiques : une étude multicentrique française

Cardioverter-defibrillators in hypertrophic cardiomyopathy : a French multicenter study

Abstract

Introduction: Patients with hypertrophic cardiomyopathy (HCM) may sometimes be at high risk of sudden cardiac death (SCD). Implantable cardioverter-defibrillators (ICD) are efficient in prolonging life by terminating life threatening ventricular arrhythmias, at a price of devicerelated complications. The aim of this observational multicenter study is to report the outcomes of ICD during a long follow-up in this particular population. Methods: HCM patients implanted with and ICD for primary or secondary prevention in 6 different French centers between May 1992 and June 2016 were included. Clinical characteristics, SCD risk factors, appropriate ICD interventions, and complications were recorded. Results: 270 consecutive patients (189 men, mean age 46.2 years) were included for a mean follow-up of 5.5 years: 197 (73%) implanted for primary prevention, 73 (27%) for secondary prevention. ICD intervention appropriately terminated ventricular arrhythmias (VA) in 78 patients (28.9%, 5.3%/year). Intervention rates were 4.3%/year for primary prevention and 6.9%/year for secondary prevention. The only risk factors associated with appropriate interventions were NSVT and lower LVEF (p<0.001 and p=0.009 respectively). First VA was a VT in 53% of cases. The rate of appropriate ICD interventions was higher in patients who underwent defibrillation testing at implant (69% vs. 48.5%, p=0.007). During follow-up, 80 patients (29.6%, 5.4%/year) experienced at least one ICD-related complication. 39 of them (14.4%, 2.6%/year) experienced inappropriate shocks, mostly due to rapid atrial fibrillation (37%). 17 patients (6.3%) died during the follow-up. Conclusion: ICD interventions for VA were frequent in this population, with a similar incidence of ICD-related complications. There was an important proportion of VT compared to VF for the first ventricular event and a higher proportion of defibrillation testing in the appropriate ICD intervention subgroup.Non disponible/Not available
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Dates and versions

hal-01931965 , version 1 (23-11-2018)

Identifiers

  • HAL Id : hal-01931965 , version 1

Cite

Pierre-Cyril Flechon. Cardioverter-defibrillators in hypertrophic cardiomyopathy : a French multicenter study. Sciences du Vivant [q-bio]. 2016. ⟨hal-01931965⟩
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