PMID- 9391285
OWN - NLM
STAT- MEDLINE
DCOM- 19971217
LR  - 20190503
IS  - 1355-6037 (Print)
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 78
IP  - 3
DP  - 1997 Sep
TI  - Long-term follow up of patients with implantable cardioverter-defibrillators and 
      mild, moderate, or severe impairment of left ventricular function.
PG  - 243-9
AB  - OBJECTIVE: To determine whether patients with life threatening ventricular 
      tachyarrhythmias, impaired left ventricular function, and severe heart failure 
      will benefit from implantable cardioverter-defibrillator (ICD) treatment. DESIGN: 
      410 patients were followed up after ICD implant. Left ventricular function was 
      assessed by the New York Heart Association (NYHA) functional class of heart 
      failure: 50 patients (12%) were in NYHA I-II, 151 (37%) in NYHA II, 117 (29%) in 
      NYHA II-III, and 92 (22%) in NYHA III. Epicardial ICD implantation was performed 
      in 209 patients (51%) and 201 patients (49%) received non-thoracotomy ICDs. 
      RESULTS: Perioperatively, 12 patients (3%) died, more often after epicardial ICD 
      implant (11/209 patients, 5%) than after transvenous implant (1/201 patients, < 
      1%) (P < 0.05). During a mean (SD) follow up of 28 (24) months (range < 1 to 114 
      months), 90 patients (23%) died: nine (2%) died from sudden arrhythmia; five (1%) 
      also died suddenly but probably not from arrhythmic causes; 55 (14%) died from 
      cardiac causes (congestive heart failure, myocardial reinfarction); 21 (5%) died 
      from non-cardiac causes. The three year, five year, and seven year survival was 
      92-96% for arrhythmic mortality in NYHA class I, II and III, compared to a three 
      year survival of 94% and a five year and seven year survival of 84% for patients 
      in NYHA class II-III. 338 patients (82%) received ICD shocks (21 (SD 43) shocks 
      per patient); patients in NYHA class II (83%), class II-III (84%), and class III 
      (90%) received ICD discharges more often than those in class I-II (64%) (P < 
      0.05). The mean (SD) time interval between ICD implant and the first ICD shock 
      was shorter in NYHA class II (16 (17) months), class II-III (19 (27) months), and 
      class III (16 (19) months) than in class 0-I (22 (24) months) (P < 0.05). 
      CONCLUSIONS: Patients with mild, moderate, and severe left ventricular 
      dysfunction benefit from ICD treatment and these patients survive for a 
      considerable time after the first shock. Survival is influenced by the degree of 
      left ventricular dysfunction; aggressive treatment of heart failure is necessary 
      as well as ICD therapy.
FAU - Trappe, H J
AU  - Trappe HJ
AD  - Department of Cardiology and Angiology, University Hospital Herne, Ruhr 
      University Bochum, Germany.
FAU - Wenzlaff, P
AU  - Wenzlaff P
FAU - Pfitzner, P
AU  - Pfitzner P
FAU - Fieguth, H G
AU  - Fieguth HG
LA  - eng
PT  - Journal Article
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - *Defibrillators, Implantable
MH  - Electric Countershock/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/mortality/*therapy
MH  - Humans
MH  - Life Tables
MH  - Male
MH  - Middle Aged
MH  - Statistics, Nonparametric
MH  - Survival Rate
MH  - Tachycardia, Ventricular/mortality/*therapy
MH  - Ventricular Dysfunction, Left/mortality/*therapy
PMC - PMC484925
EDAT- 1997/12/10 00:00
MHDA- 1997/12/10 00:01
PMCR- 2000/09/01
CRDT- 1997/12/10 00:00
PHST- 1997/12/10 00:00 [pubmed]
PHST- 1997/12/10 00:01 [medline]
PHST- 1997/12/10 00:00 [entrez]
PHST- 2000/09/01 00:00 [pmc-release]
AID - 10.1136/hrt.78.3.243 [doi]
PST - ppublish
SO  - Heart. 1997 Sep;78(3):243-9. doi: 10.1136/hrt.78.3.243.