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- Title
The Implantable Cardioverter-Defibrillator: Clinical Results.
- Authors
Palatianos, George M.; Thurer, Richard J.; Cooper, Deborah K.; Georgakakis, George E.; Tucker, Robert L.; Fernandez, Pedro; Interian Jr., Alberto; Myerburg, Robert J.
- Abstract
To evaluate the effectiveness of the automatic implantable cardioverter-defibrillator (AICD), a 7-year experience, from 1983-1990, was reviewed. A total of 111 patients received an AICD device. Their ages ranged between 8 and 83 years. Mean age was 63.9 years. There were 91 men and 20 women. Eighty of the patients received the AICD following an out-of-hospital cardiac arrest, while 31 were suffering from intermittent symptomatic ventricular tachycardia. The underlying etiology in 97 patients (87%) was ischemic coronary artery disease, in 11 patients (10%) dilated cardiomyopathy, and in 3 patients (3%) idiopathic ventricular fibrillation. Mean ejection fraction was 33.2%. Implantation of the AICD was performed via a left thoracotomy in 39 patients, median sternotomy in 49 patients and subxiphoid-subcostal approach in 23 patients. In-hospital mortality occurred in one patient who suffered an acute myocardial infarction 4 hours postoperatively. Out-of-hospital mortality was observed in 19 patients. There were two arrhythmic deaths. Follow-up was available for 107 patients. Mean follow-up was 33.1 months. Sixty-six patients (62%) had AICD shocks. The initial appropriate shocks occurred during the first postimplantation year in 91% of the patients. In 53 of the survivors, initial AICD shocks took place within 4.4 ± 4.7 months from implantation. Thirteen of the 20 patients who died had received appropriate AICD shocks. In these patients, the time between implantation and first shock was 2.7 ± 3.6 months whereas the time between implantation and death was 11.3 ± 10.3 months (NS). We conclude that the AICD is effective in converting ventricular tachyarrhythmias and prolongs survival.
- Subjects
IMPLANTABLE cardioverter-defibrillators; IMPLANTED cardiovascular instruments; DEFIBRILLATORS; HEART failure; CORONARY disease; ARRHYTHMIA; TACHYCARDIA
- Publication
Pacing & Clinical Electrophysiology, 1991, Vol 14, Issue 2, p297
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.1991.tb05110.x