Long-term Results for Sudden Cardiac Death Prevention of Implantable Cardioverter-defibrillator in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy / 中国循环杂志

ABSTRACT

Objective:Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare inherited cardiomyopathy,which may cause frequent ventricular arrhythmia or even sudden cardiac death (SCD).We observed the long-term follow-up result of high risk ARVC patients received an implantable cardioverter-defibrillator(ICD).Methods:We retrospectively collected ARVC patients with ICD who were treated in our hospital from 1996-12 to 2015-09 for their in-hospital and clinical records and conducted follow-up study.Results:A total of 39 ARVC patients were enrolled including 32 (82.1％) males,the mean age at diagnosis was (42.1±14.8) years and 33 (84.6％) patients suffered from persistent ventricular tachycardia (VT) or ventricular fibrillation (VF) prior to ICD therapy.The median follow-up time was 48.6 (32.3-73.3) months and 7 (7.7％) patients died during that period including 1 sudden death,1 heart failure and 1 cerebral infarction.28 (71.8％) patients received 540 appropriate ICD interventions,5 (12.8％) of them received the first appropriate ICD intervention more than 2 years after initial implantation procedure.12 (30.8％) patients experienced electrical storm and 7 (17.9％) of them with electrical storm more than 2 years after initial implantation procedure.The patients without broad precordial T wave inversion (TWI ≥V1～3) had a shorter eventfree survival period (HR=0.39,95％ CI 0.16-0.96).The application rates of antiarrhythmic drugs and radiofrequency catheter ablation before ICD therapy were similar in patients with or without appropriate ICD intervention,P＞0.05.Conclusion:High risk ARVC patients have frequent ventricular arrhythmia,ICD therapy could effectively stop VT/VF,which was the most reliable method to prevent sudden cardiac death.