ICD/CRT-D Registry Ain Shams University Hospitals

Abstract

Abstract Background The idea of the ICD registry was prompted from the National Coverage Decision that was published by the Centers for Medicare and Medicaid Services (CMS) in 2005 and based on the Sudden Cardiac Death in Heart Failure Trial, Ain Shams University Hospitals aim to take the lead by documenting the first ICD/CRT-D Registry in Egypt. Aim of the Work To capture the characteristics, treatments, and outcomes of patients receiving ICDs to improve care for patients receiving ICDs and CRT-Ds in Egypt. Methods 102 consecutive patient that received an ICD/CRT-D (initial or generator change) for primary or secondary prevention of SCD and came for ICD/CRT-D follow up at Ain Shams University hospitals pacemaker outpatient clinics in a timeline of one year (7-2019 till 11-2020). Results Males were around two thirds of cases (68.6%), and more than half of cases (52%) were smokers. Implantation for primary prevention of SCD was in 58.8% of patients. Most of cases had their ICDs follow-up at a time between 1 to 3 years after implantation. HFrEF was significantly more common in primary prevention group (93.3%) of patients of primary prevention group, while IsHD was the most common comorbidity in patients that had ICD implantation for secondary prevention of SCD (66.7% of them). Total complication rate was 6.86% including, pocket hematoma occurred in 2.9% of cases, and lead dislodgment that required repositioning without a plan to add a transvenous lead occurred in 3.9% of cases. Beta Blockers and Amiodarone were the most common drugs used among patients as regard 88.2% and 65.7% respectively. VTs and NSVTs were the most frequent post implantation events among the studied cases 45.1% and 42.2% respectively. 52% of patients had ATP therapy to events, Failed ATP therapy occurred in 60% of them. 33.3% of patient received ICD shock therapy, Inappropriate Shocks was in 20.6% of them. 50.9% of the patients had a bradycardia pacing as about 34% of patient had CRT-D for pump failure. VF detection zone interval was significantly longer in primary prevention group. No significant differences according to implantation indication regarding VT2 zone interval. Regarding VT1 zone; monitor only was the mainly action in 58.7% of patients. Only 20.6% of patients had VT1 zone off. Conclusion This observational and descriptive study provides strong evidence that ICD has an effective role to improve survival in primary and secondary prevention of SCD. We noticed increase in implantation rate of ICD for primary prevention of SCD who gain great benefits from the device later on, minimal complication rate of ICD implantation.