Current Status of Primary Prevention of Sudden Cardiac Death With Implantable Cardioverter Defibrillator in Patients With Chronic Heart Failure

• DOI: 10.1253/circj.cj-14-0925
• Publication Date: 2014-12-02T18:22:45Z
• Authors: Hiroyuki Satake; Koji Fukuda; Yasuhiko Sakata; Satoshi Miyata; Makoto Nakano; Masateru Kondo; Yuhi Hasebe; Masato Segawa; Hiroaki Shimokawa
• Keywords: Primary Prevention; Fibrillation

The current status of primary prevention sudden cardiac death (SCD) with implantable cardioverter defibrillator (ICD) in patients heart failure reduced ejection fraction remains to be fully elucidated Japan.In the chronic (CHF) cohort study, CHART-2 Study, we enrolled 2,778 consecutive NYHA class II-III. According Japanese Circulation Society guideline prophylactic ICD, divided them into 3 groups: group A, I indication; B, IIa; and C, no indication. During (median) 3.2-year follow-up, 79 fatal arrhythmic events (FAE), defined as composite cardiac/arrhythmic death, ventricular tachycardia/fibrillation appropriate ICD therapy, occurred. In groups B prevalence FAE was 16.1%, 8.9% 1.9%, respectively; use among those FAE, however, only 44%, 9% 6%, respectively. A combined, atrial fibrillation (cAF) left end-diastolic dimension (LVDd) ≥ 65 mm were independent predictors and, when their prognostic impact highly significant (hazard ratio, 7.01; P<0.001).Primary SCD CHF is validated but still underused Japan, combination cAF LVDd may a useful indication implantation.