Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe

Background and Aims Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death (SCD) in arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to identify cross-continental differences in utilization of primary prevention ICDs and survival free f...

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Detalhes bibliográficos
Autores: Carrick, RT, De Marco, C, Gasperetti, A, Bosman, LP, Gourraud, JB, Trancuccio, A, Mazzanti, A, Murray, B, Pendleton, C, Tichnell, C, Tandri, H, Zeppenfeld, K, Wilde, AAM, Davies, B, Seifer, C, Roberts, JD, Healey, JS, MacIntyre, C, Alqarawi, W, Tadros, R, Cutler, MJ, Targetti, M, Calò, L, Vitali, F, Bertini, M, Compagnucci, P, Casella, M, Dello Russo, A, Cappelletto, C, De Luca, A, Stolfo, D, Duru, F, Jensen, HK, Svensson, A, Dahlberg, P, Hasselberg, NE, Di Marco, A, Jordà, P, Arbelo, E, Weidmann, ZM, Borowiec, K, Delinière, A, Biernacka, EK, van Tintelen, JP, Platonov, PG, Olivotto, I, Saguner, AM, Haugaa, KH, Cox, M, Tondo, C, Merlo, M, Krahn, AD, te Riele, ASJM, Wu, KC, Calkins, H, James, CA, Cadrin-Tourigny, J
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Recursos:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p19257
Acesso em linha:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19257
http://ddd.uab.cat/record/313094
Access Level:acceso abierto
Palavra-chave:Arrhythmogenic right ventricular cardiomyopathy
Sudden cardiac death
Ventricular arrhythmia
Primary prevention
Implantable cardioverter-defibrillator
Descrição
Resumo:Background and Aims Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death (SCD) in arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to identify cross-continental differences in utilization of primary prevention ICDs and survival free from sustained ventricular arrhythmia (VA) in ARVC.Methods This was a retrospective analysis of ARVC patients without prior VA enrolled in clinical registries from 11 countries throughout Europe and North America. Patients were classified according to whether they received treatment in North America or Europe and were further stratified by baseline predicted VA risk into low- (<10%/5 years), intermediate- (10%-25%/5 years), and high-risk (>25%/5 years) groups. Differences in ICD implantation and survival free from sustained VA events (including appropriate ICD therapy) were assessed.Results One thousand ninety-eight patients were followed for a median of 5.1 years; 554 (50.5%) received a primary prevention ICD, and 286 (26.0%) experienced a first VA event. After adjusting for baseline risk factors, North Americans were more than three times as likely to receive ICDs {hazard ratio (HR) 3.1 [95% confidence interval (CI) 2.5, 3.8]} but had only mildly increased risk for incident sustained VA [HR 1.4 (95% CI 1.1, 1.8)]. North Americans without ICDs were at higher risk for incident sustained VA [HR 2.1 (95% CI 1.3, 3.4)] than Europeans.Conclusions North American ARVC patients were substantially more likely than Europeans to receive primary prevention ICDs across all arrhythmic risk strata. A lower rate of ICD implantation in Europe was not associated with a higher rate of VA events in those without ICDs.

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