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• W4377016006 abstract "Implantable cardioverter-defibrillators (ICDs) have demonstrated efficacy in reducing mortality attributable to sustained ventricular tachyarrhythmia (VTA) and have been used for primary prevention of sudden death. However, patients with primary prevention ICDs remain at risk for first and recurrent VTA, which are associated with increased morbidity and mortality. Currently, there are limited data on factors associated with recurrent VTA after the occurrence of a first episode in this population. Improved risk stratification may help tailor advanced therapies, such as catheter ablation or antiarrhythmic medications, to patients at a high risk for recurrence. The objective of this study was to quantify the risk for recurrent VTA after the occurrence of a first VTA episode among patients with a primary prevention ICD. The population comprised patients enrolled in five landmark ICD trials (MADIT-II, MADIT-Risk, MADIT-CRT, MADIT-RIT, RAID) who experienced a first episode of VTA (defined as ventricular tachycardia [VT] ≥170 bpm or ventricular fibrillation [VF]) after ICD implantation (N=789). The primary endpoint was recurrent VTA after a first episode. All-cause mortality associated with recurrent VTA was a secondary endpoint. Among 789 study patients who experienced a first VTA after ICD implantation, mean age was 63 ± 11 years, 17% were women, 64% had ischemic cardiomyopathy, and mean left ventricular ejection fraction (EF) was 24 ± 7%. Kaplan Meier analysis showed the risk of recurrent VTA after a first episode was very high (60% at 3 years [Figure - A]). Findings were consistent regardless of baseline risk factors, including age, sex, NYHA Class, EF. Furthermore, the burden of multiple VTA episodes after a first episode was also high (average of 3.6 episodes per patient at 3 years [Figure B]). Recurrent VTA was associated with a significant two-fold increased risk of subsequent death (HR=2.15, 95% CI 1.40-3.32, p=0.001 [Figure - C]). Among primary prevention ICD recipients who experience a first VTA, the burden of recurrent VTA and subsequent mortality increase is very high regardless of baseline risk factors. Intensification of therapies, including early catheter ablation, should be considered in primary prevention ICD recipients who experience a first VTA." @default.
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• W4377016006 date "2023-05-01" @default.
• W4377016006 modified "2023-10-18" @default.
• W4377016006 title "PO-04-226 RISK OF VENTRICULAR RECURRENT TACHYARRHYTHMIA IN PATIENTS RECEIVING PRIMARY PREVENTION IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS" @default.
• W4377016006 doi "https://doi.org/10.1016/j.hrthm.2023.03.1223" @default.
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