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Artigo Acesso aberto Produção Nacional Revisado por pares
BIBTEX RIS

Acompanhamento clínico de pacientes portadores de cardioversor-desfibrilador implantável

2007; Sociedade Brasileira de Cardiologia (SBC); Volume: 88; Issue: 1 Linguagem: Inglês

10.1590/s0066-782x2007000100002

ISSN

1678-4170

Autores

Silvia Martelo Souza da Fonseca, Luiz Gustavo Belo, Hécio Carvalho, Nilson Araújo, Cláudio Munhoz, Leonardo Siqueira, Washington Maciel, Eduardo Machado Andréa, Jacob Atié,

Tópico(s)

Cardiovascular Effects of Exercise

Resumo

To report appropriate (AT) and inappropriate (IT) ICD therapies in patients with ischemic and nonischemic heart disease, as well as early and late procedure-related complications.One hundred and fifty-five patients (119 male and 36 female), mean age 47 years (21-88), who underwent ICD implantation between 1994 and March 2003 were analyzed. Patients were divided into the following groups: Group I--Post-AMI patients (n = 80); Group II--Patients with nonischemic heart disease and LV ejection fraction < 40% (n = 45), Chagas disease (n = 18), idiopathic dilated cardiomyopathy (n= 12), hypertensive disease (n = 8), hypertrophic cardiomyopathy (n = 4) and valvular heart disease (n = 3); Group III--Patients with arrhythmogenic right ventricular dysplasia (n = 13); and Group IV--Patients with channelopathies: Brugada Syndrome (n = 8) and idiopathic ventricular arrhythmias (n = 9). All patients underwent electrophysiological study (EPS) with induction of sustained ventricular arrhythmia ICD implantation.During the 26-month mean follow up, a high rate of appropriate ICD therapies (antitachycardia pacing and/or shock) was observed (46%) in the four groups, with no statistically significant difference. The four groups did not differ in either overall (8.4%) or arrhythmic mortality (1.3%). There was no correlation between appropriate ICD therapies and initial clinical presentation or inducible ventricular arrhythmia at EPS, and a 4% incidence of early and late procedure-related complications was found.The high incidence of appropriate ICD therapy and low rate of sudden death in the patients studied suggest that ICD is a valuable strategy in the management of ischemic and nonischemic patients previously selected by means of EPS.

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