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Occurrence of implantable defibrillator events in patients with syncope and nonischemic dilated cardiomyopathy

2001; Elsevier BV; Volume: 88; Issue: 12 Linguagem: Inglês

10.1016/s0002-9149(01)02133-6

1879-1913

Andrea M. Russo, Ralph J. Verdino, Christa Schorr, Maureen Nicholas, Darryl Dias, Henry H. Hsia, David J. Callans, Francis E. Marchlinski,

Cardiac pacing and defibrillation studies

Syncope is a known predictor of poor outcome and sudden death in patients with a nonischemic dilated cardiomyopathy. 1 Middlekauff H.R. Stevenson W.G. Stevenson L.W. Saxon L.A. Syncope in advanced heart failure high risk of sudden death regardless of origin of syncope. J Am Coll Cardiol. 1993; 21: 110-116 Abstract Full Text PDF PubMed Scopus (272) Google Scholar , 2 Fruhwald F.M. Eber B. Schumacher M. Zwieker R. Watzinger N. Klein W.W. Syncope in dilated cardiomyopathy is a predictor of sudden cardiac death. Cardiology. 1996; 87: 177-180 Crossref PubMed Scopus (39) Google Scholar Electrophysiologic testing often reveals no inducible sustained ventricular arrhythmias, and has a poor predictive value in this patient population. 3 Grimm W. Hoffmann J. Menz V. Luck K. Maisch B. Programmed ventricular stimulation for arrhythmia risk prediction in patients with idiopathic dilated cardiomyopathy and nonsustained ventricular tachycardia. J Am Coll Cardiol. 1998; 32: 739-745 Abstract Full Text Full Text PDF PubMed Scopus (118) Google Scholar , 4 Milner P.G. DiMarco J.P. Lerman B.B. Electrophysiological evaluation of sustained ventricular tachyarrhythmias in idiopathic dilated cardiomyopathy. PACE. 1988; 11: 562-568 Crossref Scopus (73) Google Scholar , 5 Stamato N.J. O'Connell J.B. Murdock D.K. Moran J.F. Loeb H.S. Scanlon P.J. The response of patients with complex ventricular arrhythmias secondary to dilated cardiomyopathy to programmed electrical stimulation. Am Heart J. 1986; 112: 505 Abstract Full Text PDF PubMed Scopus (40) Google Scholar , 6 Chen X. Shenasa M. Borggrefe M. Block M. Hindricks G. Martinez-Rubio A. Haverkamp W. Willems S. Bocker D. Makijarvi M. Breithardt G. Role of programmed ventricular stimulation in patients with idiopathic dilated cardiomyopathy and documented sustained ventricular tachyarrhythmias inducibility and prognostic value in 102 patients. Eur Heart J. 1994; 15: 76-82 PubMed Google Scholar Implantable cardioverter-defibrillators (ICDs) are frequently recommended in these patients. However, there are limited long-term data regarding the frequency of appropriate defibrillator therapy for sustained ventricular arrhythmias in patients with nonischemic dilated cardiomyopathies presenting with sustained ventricular arrhythmias or syncope. 6 Chen X. Shenasa M. Borggrefe M. Block M. Hindricks G. Martinez-Rubio A. Haverkamp W. Willems S. Bocker D. Makijarvi M. Breithardt G. Role of programmed ventricular stimulation in patients with idiopathic dilated cardiomyopathy and documented sustained ventricular tachyarrhythmias inducibility and prognostic value in 102 patients. Eur Heart J. 1994; 15: 76-82 PubMed Google Scholar , 7 Grimm W. Marchlinski F.E. Shock occurrence and survival in 49 patients with idiopathic dilated cardiomyopathy and an implantable cardioverter-defibrillator. Eur Heart J. 1995; 16: 218-222 PubMed Google Scholar , 8 Knight B.P. Goyal R. Pelosi F. Flemming M. Horwood L. Morady F. Strickberger A. Outcome of patients with nonischemic dilated cardiomyopathy and unexplained syncope treated with an implantable defibrillator. J Am Coll Cardiol. 1999; 33: 1965-1970 Google Scholar , 9 Fonarow G.C. Feliciano Z. Boyle N.G. Knight L. Woo M.A. Moriguchi J.D. Laks H. Wiener I. Improved survival in patients with nonischemic advanced heart failure and syncope treated with an implantable cardioverter-defibrillator. Am J Cardiol. 2000; 85: 981-985 Abstract Full Text Full Text PDF PubMed Scopus (95) Google Scholar , 10 Fazio G. Veltri E.P. Tomaselli G. Lewis R. Griffith L.S. Guarnieri T. Long-term follow-up of patients with nonischemic dilated cardiomyopathy, and ventricular tachyarrhythmias treated with implantable cardioverter defibrillators. PACE. 1991; 14: 1905-1910 Crossref Scopus (42) Google Scholar The present study examines the frequency of appropriate and inappropriate ICD therapy in patients with dilated cardiomyopathy presenting with syncope, without documented clinical sustained ventricular arrhythmias.