Prognosis of Type 2 Myocardial Infarction Patients Implanted With a Prophylactic Defibrillator (from the Very-High-Rate Registry)

Abstract

An implantable cardioverter defibrillator (ICD) is recommended in primary prevention patients with a coronary artery disease (CAD) and reduced left ventricular ejection fraction. Benefits of ICD in CAD unrelated to coronary thrombosis are unknown. We sought to compare the prognosis of patients with CAD implanted with a prophylactic ICD according to the type of myocardial infarction (MI). Patients from the Very-High-Rate registry implanted with a prophylactic ICD for CAD between 2006 and 2016 were retrospectively included. Cardiac resynchronization therapy patients were excluded. Patients with type 2 MI were matched (1:4) with patients with type 1 MI using propensity score. The following events were collected: death, hospitalization for heart failure, cardiac transplantation, and appropriated therapies on ventricular arrhythmia (≥220 beats/min). Among 571 consecutive ischemic patients, 65 type 2 MI patients were matched to 260 type 1. After a mean follow up of 55 ± 36 months, 63 patients (24%) died in type 1 group, 18 (28%) in type 2 group (p = 0.19). Survival rate from appropriate therapies on high-rate ventricular arrhythmias was significantly lower in type 2 group (p = 0.04). In conclusion, patients implanted with a prophylactic ICD for severe CAD, whether type 1 or type 2 MI, have similar outcomes.