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Clinical Outcomes of Implantable Cardioverter Defibrillators in Heart Failure: A Comparative Analysis between Ischemic and Non-Ischemic Cardiomyopathy Patients
Session:
Sessão de Posters 40 - Insuficiência cardíaca - da Preservada ao Transplante
Speaker:
Inês Ferreira Neves
Congress:
CPC 2024
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.6 Chronic Heart Failure - Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
Inês Ferreira Neves; Julien Lopes; Guilherme Portugal; Rita Teixeira; Pedro Silva Cunha; Bruno Valente; Ana Lousinha; Paulo Osório; Hélder Santos; André Monteiro; Rui Cruz Ferreira; Mário Martins Oliveira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt">Introduction:</span></strong><span style="font-size:10.0pt"> In individuals with Heart Failure with Reduced Ejection Fraction (HFrEF), a considerable number of fatalities result from electrical disturbances, such as ventricular arrhythmias. Implantable cardioverter defibrillators (ICDs) are recommended for primary prevention in patients with symptomatic Heart Failure (HF), with a left ventricular ejection fraction (LVEF) ≤35%, following a minimum of three months of optimal medical therapy (OMT). The implantation of an ICD in these patients is a class I recommendation in the most recent European Society of Cardiology (ESC) Guidelines (level of evidence A) for patients with ischemic etiology, but the evidence is less strong for patients of a non-ischemic cardiomyopathy (NICM). We aimed to compare the outcomes of ICD implantation in patients with ischemic heart disease (IHD) and NICM.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt">Methods: </span></strong><span style="font-size:10.0pt">All patients with HFrEF, symptomatic (New York Heart Association [NYHA] class II-III) and with LVEF </span><span style="font-size:10.0pt">≤</span><span style="font-size:10.0pt">35% after 3 months of OMT who were implanted with ICD for primary prevention at our center between 2015 and 2022 were included. ICD therapies, including Anti Tachycardia Pacing (ATP) and shock were recorded during follow-up. We retrospec</span><span style="font-size:10.0pt">ti</span><span style="font-size:10.0pt">vely analyzed the time to event (ICD therapy) in patients with IHD and NICM. A cox regression model was used with time to event and Kaplan-Meier survival curve was calculated.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt">Results: </span></strong><span style="font-size:10.0pt">289 patients (82.4% males, age 62±11.3 </span><span style="font-size:9.0pt">[</span><span style="font-size:10.0pt">between 50 and 73 years]) were included. 195 (67.5%) had IHD and 94 (32.5%) had NICM. There were no statistically significant differences between the groups. After one year, there were no significant differences in the number of therapies delivered by the ICD between the groups, with a <em>p value</em> of 0.318. In cox regression, the non-ischemic etiology of the cardiomyopathy was not associated with a reduced risk of ICD therapy (hazard ratio [HR] 1.05; 95% confidence interval [CI] 0.58-1.89). There were no significant differences in the “free from ICD therapy” survival curves.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt">Conclusion: </span></strong><span style="font-size:10.0pt">The outcomes of ICD implantation in patients with IHD and NICM, regarding ICD therapy, did not differ in or population of patients with HFrEF.</span></span></span></p>
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