Outcomes in patients with cardiac amyloidosis and implantable cardioverter-defibrillator

• DOI: 10.1093/europace/euaa094
• Publication Date: 2020-04-03T19:10:52Z
• Authors: Eun-Jeong Kim; Benjamin B Holmes; Shi Huang; Ricardo Lugo; Asad Al Aboud; Stacey Goodman; Rebecca R Hung; David Slosky; William G Stevenson; Gregory F Michaud; Roy M John
• Keywords: Cardiac Amyloidosis

Abstract Aims Cardiac amyloidosis (CA) is associated with increased mortality due to arrhythmias, heart failure, and electromechanical dissociation. However, the role of an implantable cardioverter-defibrillator (ICD) remains unclear. We conducted case-control study assess survival in CA patients without a primary prevention ICD compared outcomes age, sex, device implant year-matched non-CA group ICD. Methods results There were 91 subjects [mean age= 71.2 ± 10.2, female 22.0%, 49 AL Mayo Stage 2.9 1.0, 41 transthyretin (ATTR), 1 other] followed by Vanderbilt Amyloidosis centre. Patients (n = 23) those 68) non-amyloid 46). All had implantation for prevention. Mean left ventricular ejection fraction was 36.2% 14.4% ICD, 41.0% 10.6% 33.5% patients. Over 3.5 3.1 years, 6 (26.1%) CA, 12 received therapies (P 0.71). significantly higher (43.9% vs. 17.4%, P 0.002) group. time from death 21.8 months 22.8 ATTR no significant difference between who did not receive (39.0% 46.0%, 0.59). Conclusions Despite comparable event rates ICDs longer survival. With emergence effective therapy amyloidosis, further needed this