Abstract

Little is known regarding the role of LVEF in ventricular arrhythmia recurrence. The aim of this study was to assess the correlation between LVEF and ventricular arrhythmia recurrence in patients with ischemic (ICM) or non ischemic (NICM) cardiomyopathies implanted with an Implantable Cardiac Defibrillator (ICD) for secondary prevention. Data on all consecutive patients implanted with an ICD were retrieved from the database of our institution. Among 1334 patients implanted with an ICD, 554 had their device for secondary prevention and 307 had a history of ICM or NICM. The total ICD therapies (shocks and ATP), ATP only and shocks only were collected. We compared the proportion of patients receiving ICD therapies in 2 groups: group 1 (patients with a LVEF >35%) and group 2 (patients with a LVEF<= 35%). Among 307 patients (mean age 64 +/-10, 29 women), 157 received ICD therapies. The proportion of patients receiving total ICD therapies was higher in group 1 than in group 2 (72.1 vs. 57.1% p< 0.01). There was no difference regarding the proportion of patients receiving total appropriate ICD therapies, appropriate ATP therapies and appropriate shocks, between group 1 and group 2 (60.3 vs. 52.9% p=NS; 38.2 vs. 37.6 p=NS; 22.1 vs 15.3% p=NS; respectively). The proportion of patients receiving inappropriate total ICD therapies was higher in group 1 than in group 2 (11.8 vs. 4.2% p< 0.05). The proportion of patients receiving inappropriate ATP therapies was higher in group 1 than in group 2 (8.8 vs. 3.1% p< 0.05). There was no difference regarding the proportion of patients receiving inappropriate shocks between group 1 and group 2 (2.9 vs. 2.1% p=NS). LVEF is not correlated with ventricular arrhythmia recurrence in patients with DCM or ICM implanted with an ICD for secondary prevention. However, the proportion of patients receiving inappropriate ICD therapies was higher in patient with a LVEF>35% than in patients with a LVEF<=35%.

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