Implantation of a Totally Subcutaneous ICD in Children (original) (raw)

2011, Heart, Lung and Circulation

Background: We examined all patients receiving a new ICD implant at Wellington Hospital between January 2001 and December 2005 to determine long-term outcomes in this patient population Methods: Follow up data were collected and Kaplan-Meier curves were constructed for survival and long-term outcomes. Results: In the study period 138 new ICDs were implanted, and the mean follow-up time was 85 months ± 17 months. Seventy-six percent of patients were male, 75% were European, 20% were Maori. Median age was 60 years (range 16-80 years). Fifty percent of patients had an ischaemic substrate. Seventy-four percent of ICDs were implanted for secondary prevention. The seven-year survival was 72.5%. No difference in mortality was observed between primary and secondary prevention groups. There was a trend towards increased mortality amongst males. The seven-year appropriate shock therapy rate was 57%. Appropriate shocks were more common in secondary prevention than in primary prevention patients (62% vs. 37%, hazard ratio 2.11, 95% CI 1.16-3.85). Twentyfour percent of patients received inappropriate shock therapy. This was more common in patients with prior atrial fibrillation (hazard ratio 3.32, 95% CI 1.66-6.67). The median lifespan of implanted devices was 81 months. The seven-year all cause hospitalisation was 85%, with sevenyear cardiac-cause hospitalisation being 76%. Conclusions: This is the first long-term follow-up study of ICD patients in New Zealand. Higher rates of implantation for secondary prevention and appropriate shock therapy were observed compared with other published registries. Rates of inappropriate shock therapy were similar to those in recently published reviews.

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