Comparing outcome of patients with coronary artery disease and dilated cardiomyopathy in ICD and CRT recipients: data from the German DEVICE—registry

Abstract

The purpose of this study was to evaluate whether there are differences in use and outcome of implantable cardioverter defibrillator (ICD) therapy with or without cardiac resynchronization therapy (CRT) between patients with underlying coronary artery disease (CAD) and non-ischemic dilated cardiomyopathy (DCM). A total of 2,263 consecutive patients from 44 German centers who underwent new ICD or CRT implantation between March 2007 and April 2010 were enrolled in the German DEVICE registry. Patients were followed for at least 1 year. Of 1,621 patients who received an ICD, 1,202 (74.2%) had CAD and 419 (25.8%) suffered from DCM. Patients who received CRT (n = 642) had CAD in 52.2% and DCM in 47.8%. The vast majority received CRT with ICD backup (CRT-D, 95%). In both ICD and CRT groups, CAD patients were older and more often male. LV ejection fraction in ICD patients with CAD was significantly higher than in DCM patients. Heart failure classification and history of atrial fibrillation were similar in CAD and DCM in CRT patients. There was no significant difference in mortality and first ICD shock delivery between CAD and DCM after 1 year of follow-up. Heart failure symptoms showed significant improvement in CRT patients irrespective of the underlying disease. ICD and CRT patients in the DEVICE registry showed similar short-term outcome irrespective of their underlying disease etiology. Except older age and preponderance of males, clinical characteristics, device selection and outcome of ICD or CRT patients in the German DEVICE registry are comparable with patients from randomized trials.