Identification of Patients Most Likely to Benefit From Implantable Cardioverter-Defibrillator Therapy

• DOI: 10.1161/01.cir.101.14.1660
• Publication Date: 2012-06-12T00:42:29Z
• Authors: Robert Sheldon; Stuart Connolly; Andrew Krahn; Robin Roberts; Michael Gent; Martin Gardner
• Keywords: Quartile

Background —Patients with resuscitated ventricular tachyarrhythmias (ventricular tachycardia/ventricular fibrillation) benefit from implantable cardioverter-defibrillators (ICDs) compared medical therapy. We hypothesized that the patients who most an ICD are those at greatest risk of death. Methods and Results —In Canadian Implantable Defibrillator Study (CIDS), 659 were randomly assigned to receive or amiodarone then followed for a mean 3 years. There 98 83 deaths in groups, respectively. used multivariate Cox analysis assess impact baseline parameters on mortality group. Reduced left ejection fraction, advanced age, poor NYHA status identified high-risk ( P =0.0001 0.0009). Quartiles constructed, reduction associated treatment each quartile was assessed. significant interaction between effect =0.011). In highest quartile, there 50% relative (95% CI 21% 68%) death group, whereas lower quartiles, no benefit. Patients likely can be simple score (≥2 following factors: age ≥70 years, fraction ≤35%, class III IV). Thirteen 15 prevented by occurred ≥2 factors. Conclusions CIDS, benefited These easily basis function, functional status.