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Arrhythmic and Mortality Outcomes Among Ischemic Versus Nonischemic Cardiomyopathy Patients Receiving Primary ICD Therapy.

Publication ,  Journal Article
Narins, CR; Aktas, MK; Chen, AY; McNitt, S; Ling, FS; Younis, A; Zareba, W; Daubert, JP; Huang, DT; Rosero, S; Kutyifa, V; Goldenberg, I
Published in: JACC Clin Electrophysiol
January 2022

OBJECTIVES: This study sought to determine the association of cardiomyopathy etiology with the likelihood of ventricular arrhythmias, appropriate implantable cardioverter-defibrillator (ICD) therapy, and mortality. BACKGROUND: There are conflicting data on the benefit of primary prevention ICD therapy in patients with ischemic versus nonischemic cardiomyopathy (ICM/NICM). METHODS: The study population comprised 4803 patients with ICM (n = 3,106) or NICM (n = 1,697) with a primary prevention ICD enrolled in 5 randomized trials conducted between 1997 and 2017. The primary end point was sustained ventricular tachycardia (VT) ≥200 beats/min or ventricular fibrillation (VF). Secondary end points included appropriate ICD therapy and all-cause mortality. Differences in cause-specific mortality, including noncardiac, sudden cardiac, and non-sudden cardiac death, were also examined. RESULTS: Patients with ICM were significantly older and had more comorbid conditions, whereas those with NICM had a more advanced heart failure class at enrollment and were more often prescribed medical or cardiac resynchronization therapy for heart failure. Multivariate analysis showed that ICM versus NICM had a similar risk of VT/VF events (HR: 0.98 [95% CI: 0.79-1.20]) and appropriate ICD therapy (HR: 1.03 [95% CI: 0.87-1.22]), whereas the risk of all-cause mortality was 1.8-fold higher among ICM versus NICM patients (HR: 1.84 [95% CI: 1.42-2.38]), dominated by non-sudden cardiac mortality. CONCLUSIONS: Combined data from 5 landmark ICD clinical trials show that ICM patients experience a similar risk of life-threatening ventricular arrhythmic events but have an increased risk of all-cause mortality, dominated by non-sudden cardiac death, compared with NICM patients.

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Published In

JACC Clin Electrophysiol

DOI

EISSN

2405-5018

Publication Date

January 2022

Volume

8

Issue

1

Start / End Page

1 / 11

Location

United States

Related Subject Headings

  • Tachycardia, Ventricular
  • Humans
  • Defibrillators, Implantable
  • Cardiomyopathies
  • Cardiac Resynchronization Therapy
  • Arrhythmias, Cardiac
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

APA
Chicago
ICMJE
MLA
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Narins, C. R., Aktas, M. K., Chen, A. Y., McNitt, S., Ling, F. S., Younis, A., … Goldenberg, I. (2022). Arrhythmic and Mortality Outcomes Among Ischemic Versus Nonischemic Cardiomyopathy Patients Receiving Primary ICD Therapy. JACC Clin Electrophysiol, 8(1), 1–11. https://doi.org/10.1016/j.jacep.2021.06.020
Narins, Craig R., Mehmet K. Aktas, Anita Y. Chen, Scott McNitt, Fred S. Ling, Arwa Younis, Wojciech Zareba, et al. “Arrhythmic and Mortality Outcomes Among Ischemic Versus Nonischemic Cardiomyopathy Patients Receiving Primary ICD Therapy.JACC Clin Electrophysiol 8, no. 1 (January 2022): 1–11. https://doi.org/10.1016/j.jacep.2021.06.020.
Narins CR, Aktas MK, Chen AY, McNitt S, Ling FS, Younis A, et al. Arrhythmic and Mortality Outcomes Among Ischemic Versus Nonischemic Cardiomyopathy Patients Receiving Primary ICD Therapy. JACC Clin Electrophysiol. 2022 Jan;8(1):1–11.
Narins, Craig R., et al. “Arrhythmic and Mortality Outcomes Among Ischemic Versus Nonischemic Cardiomyopathy Patients Receiving Primary ICD Therapy.JACC Clin Electrophysiol, vol. 8, no. 1, Jan. 2022, pp. 1–11. Pubmed, doi:10.1016/j.jacep.2021.06.020.
Narins CR, Aktas MK, Chen AY, McNitt S, Ling FS, Younis A, Zareba W, Daubert JP, Huang DT, Rosero S, Kutyifa V, Goldenberg I. Arrhythmic and Mortality Outcomes Among Ischemic Versus Nonischemic Cardiomyopathy Patients Receiving Primary ICD Therapy. JACC Clin Electrophysiol. 2022 Jan;8(1):1–11.
Journal cover image

Published In

JACC Clin Electrophysiol

DOI

EISSN

2405-5018

Publication Date

January 2022

Volume

8

Issue

1

Start / End Page

1 / 11

Location

United States

Related Subject Headings

  • Tachycardia, Ventricular
  • Humans
  • Defibrillators, Implantable
  • Cardiomyopathies
  • Cardiac Resynchronization Therapy
  • Arrhythmias, Cardiac
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology