PMID- 27343008
OWN - NLM
STAT- MEDLINE
DCOM- 20170315
LR  - 20170817
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 39
IP  - 9
DP  - 2016 Sep
TI  - Early Implantation of Primary Prevention Implantable Cardioverter Defibrillators 
      for Patients with Newly Diagnosed Severe Nonischemic Cardiomyopathy.
PG  - 992-8
LID - 10.1111/pace.12911 [doi]
AB  - BACKGROUND: Primary prevention implantable cardioverter defibrillators (ICDs) 
      reduce mortality in selected patients with severe systolic dysfunction. Current 
      guidelines suggest a 3- to 6-month waiting period before implantation. METHODS: 
      We retrospectively studied 29 consecutive patients with newly diagnosed 
      nonischemic cardiomyopathy (NICM) who underwent primary prevention ICD 
      implantation within 6 months of diagnosis between January 2008 and April 2014. 
      Cardiac MRI (CMR) evaluated left ventricular ejection fraction (LVEF) and 
      regional fibrosis preimplant. The primary end point was "failure to qualify for 
      an ICD at 12 months postimplant," either due to LVEF >/= 35% or deterioration 
      necessitating mechanical support or transplantation, without appropriate ICD 
      therapy. Secondary end points were appropriate and inappropriate ICD therapy. 
      RESULTS: Baseline mean age was 44.2 +/- 14.8 years and median LVEF 16.4%. Median 
      time from diagnosis to implant was 32 days. At 12 months, 17 patients (58.6%) no 
      longer qualified for an ICD, mainly due to LVEF improvement. At follow-up (mean 
      32.0 +/- 20.6 months), three patients received appropriate therapy (one for 
      ventricular fibrillation). All three had CMR late gadolinium enhancement (LGE) 
      and nonsustained ventricular tachycardia (NSVT) preimplant. Cardiac 
      resynchronization at implant predicted LVEF improvement. CONCLUSION: Early 
      appropriate therapy, particularly for ventricular fibrillation, is infrequent for 
      patients with very severe NICM who have ICDs implanted within 6 months of 
      diagnosis. The majority of these patients would not qualify for an ICD at 12 
      months postinsertion. In the absence of a multimodality risk score, early ICD 
      insertion should only be considered in selected cases (presence of LGE and NSVT). 
      Wearable cardioverter defibrillators may have a role as a bridge to ICD decision.
CI  - (c) 2016 Wiley Periodicals, Inc.
FAU - Voskoboinik, Aleksandr
AU  - Voskoboinik A
AD  - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia. 
      alex.voskoboinik@gmail.com.
FAU - Bloom, Jason
AU  - Bloom J
AD  - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia.
FAU - Taylor, Andrew
AU  - Taylor A
AD  - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia.
AD  - Baker IDI Heart & Diabetes Research Institute, Melbourne, Victoria, Australia.
FAU - Mariani, Justin
AU  - Mariani J
AD  - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia.
AD  - Department of Cardiology, St. Vincent's Hospital, Melbourne, Victoria, Australia.
LA  - eng
PT  - Journal Article
DEP - 20160723
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Adult
MH  - Cardiomyopathies/*diagnosis/*prevention & control
MH  - *Defibrillators, Implantable
MH  - *Early Diagnosis
MH  - Female
MH  - Humans
MH  - Male
MH  - Primary Prevention/*methods
MH  - Prosthesis Implantation/methods
MH  - Retrospective Studies
MH  - Secondary Prevention/*methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - arrhythmia
OT  - cardiomyopathy
OT  - cardioverter defibrillator
OT  - sudden death
EDAT- 2016/06/28 06:00
MHDA- 2017/03/16 06:00
CRDT- 2016/06/26 06:00
PHST- 2016/03/17 00:00 [received]
PHST- 2016/05/14 00:00 [revised]
PHST- 2016/06/17 00:00 [accepted]
PHST- 2016/06/26 06:00 [entrez]
PHST- 2016/06/28 06:00 [pubmed]
PHST- 2017/03/16 06:00 [medline]
AID - 10.1111/pace.12911 [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2016 Sep;39(9):992-8. doi: 10.1111/pace.12911. Epub 
      2016 Jul 23.