ABSTRACT
Los pacientes incluidos en lista de espera de trasplante cardiaco frecuentemente presentan un perfil acorde a las recomendaciones actuales en cuanto al implante de desfibrilador automático implantable como prevención primaria de muerte súbita. El eventual trasplante a corto-medio plazo hace dudar de la efectividad de dicha terapia. Analizamos la incidencia de terapias administradas por el desfibrilador implantado como prevención primaria en pacientes en lista, así como la evolución histórica en la frecuencia de muerte súbita en nuestro centro. Se revisaron los 308 pacientes incluidos en lista desde 1998 hasta 2008. En 17 pacientes se indicó desfibrilador automático implantable como prevención primaria al momento de la inclusión. El 53% de éstos recibió terapias adecuadas, habiendo portado el dispositivo una media de 7,8 meses (±4,8). Sólo 1 paciente presentó terapias inadecuadas y ninguno sufrió complicaciones asociadas al dispositivo. La frecuencia de muerte súbita se ha reducido a lo largo de los últimos años(AU)
Patients who are on a waiting list for cardiac transplantation often have a clinical profile that satisfies current recommendations for the implantation of an implantable cardioverterdefibrillator for the primary prevention of sudden death. The prospect that transplantation may take place within the shortto- medium term puts the effectiveness of this therapy in doubt. We investigated the incidence of therapy delivered by implantable cardioverterdefibrillators implanted for primary prevention in patients awaiting cardiac transplantation. Recent changes in the incidence of sudden death at our center were also investigated. Data on 308 patients listed for heart transplantation between 1998 and 2008 were reviewed. An implantable cardioverterdefibrillator was indicated for primary prevention at initial evaluation in 17 patients. Of these, 53% received appropriate implantable cardioverterdefibrillator therapy while carrying an implantable cardioverterdefibrillator for amean period of 7.8months (+/-4.8). Only one patient received inappropriate therapy and none had any complications associated with device use. The frequency of sudden death has decreased over the course of recent years(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Defibrillators, Implantable/trends , Defibrillators, Implantable , Defibrillators , Primary Prevention/methods , Primary Prevention/trends , Death, Sudden/pathology , Death, Sudden/prevention & control , Heart Transplantation/pathology , Arrhythmias, Cardiac/complications , Arrhythmias, Cardiac/diagnosis , Hemodynamics , Retrospective Studies , Echocardiography/trends , EchocardiographyABSTRACT
Patients who are on a waiting list for cardiac transplantation often have a clinical profile that satisfies current recommendations for the implantation of an implantable cardioverter-defibrillator for the primary prevention of sudden death. The prospect that transplantation may take place within the short-to-medium term puts the effectiveness of this therapy in doubt. We investigated the incidence of therapy delivered by implantable cardioverter-defibrillators implanted for primary prevention in patients awaiting cardiac transplantation. Recent changes in the incidence of sudden death at our center were also investigated. Data on 308 patients listed for heart transplantation between 1998 and 2008 were reviewed. An implantable cardioverter-defibrillator was indicated for primary prevention at initial evaluation in 17 patients. Of these, 53% received appropriate implantable cardioverter-defibrillator therapy while carrying an implantable cardioverter-defibrillator for a mean period of 7.8 months (±4.8). Only one patient received inappropriate therapy and none had any complications associated with device use. The frequency of sudden death has decreased over the course of recent years.
Subject(s)
Death, Sudden/prevention & control , Defibrillators, Implantable , Heart Transplantation , Primary Prevention , Female , Humans , Male , Middle Aged , Retrospective Studies , Waiting ListsABSTRACT
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