Modes of death in defibrillator patients: Learning from clinical experience

Abstract

Historically, mortality rates from trials with implantable cardioverter-defibrillator (ICD) treatment arms for primary and secondary prevention have ranged from 6% to 8%. 1 Moss A.J. Hall W.J. Cannom D.S. et al. Multicenter Automatic Defibrillator Implantation Trial InvestigatorsImproved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med. 1996; 335: 1933-1940 Crossref PubMed Scopus (3537) Google Scholar , 2 Moss A.J. Zareba W. Hall W.J. et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002; 346: 877-883 Crossref PubMed Scopus (5558) Google Scholar , 3 Connolly S.J. Gent M. Roberts R.S. et al. Canadian Implantable Defibrillator Study (CIDS): a randomized trial of the implantable cardioverter defibrillator against amiodarone. Circulation. 2000; 101: 1297-1302 Crossref PubMed Scopus (1357) Google Scholar , 4 The AVID InvestigatorsCauses of death in the Antiarrhythmics Versus Implantable Defibrillators (AVID) Trial. J Am Coll Cardiol. 1999; 34: 1552-1559 Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar Mortality rates for cardiac resynchronization therapy with defibrillators (CRT-D) have ranged from 9% to 12%. 5 Bristow M.R. Saxon L.A. Boehmer J. et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004; 350: 2140-2150 Crossref PubMed Scopus (4734) Google Scholar , 6 Cleland J.G. Daubert J.C. Erdmann E. et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005; 352: 1539-1549 Crossref PubMed Scopus (5130) Google Scholar Annual heart failure mortality rates have been reported at ∼3% 4 The AVID InvestigatorsCauses of death in the Antiarrhythmics Versus Implantable Defibrillators (AVID) Trial. J Am Coll Cardiol. 1999; 34: 1552-1559 Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar , with sudden cardiac death rates at 20%–27% in primary prevention trials (MADIT-I, MADIT-II) and 30%–36% in secondary prevention trials (AVID, CIDS). The mode of death in implantable cardioverter-defibrillator and cardiac resynchronization therapy with defibrillator patients: Results from routine clinical practiceHeart RhythmVol. 9Issue 10PreviewAlthough data on the mode of death of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy with defibrillator (CRT-D) patients have been examined in randomized clinical trials, in routine clinical practice data are scarce. To provide reasonable expectations and prognosis for patients and physicians, this study assessed the mode of death in routine clinical practice. Full-Text PDF