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The role of implantable cardioverter defibrillators in non VT/VF sudden deaths. Pacing Clin Electrophysiol 1994 Jul;17(7):1264-6

Date

07/01/1994

Pubmed ID

7937232

DOI

10.1111/j.1540-8159.1994.tb01493.x

Scopus ID

2-s2.0-0028021228 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

Implantable cardioverter defibrillator (ICD) therapy has been an impressive success in preventing sudden cardiac death (SCD). Electrocardiographic documentation of SCD in ICD patients has been rare, but usually arrhythmias other than ventricular tachycardia/ventricular fibrillation (VT/VF; asystole and electromechanical dissociation [EMD]) have been implicated. This raises the question whether backup bradycardia pacing can prevent deaths due to asystole and EMD in such patients. We studied the outcome of 88 patients with permanent bradycardia pacemakers and compared them to 500 consecutive nonpacemaker patient controls, sustaining out-of-hospital cardiac arrest and undergoing resuscitation by paramedics. Mean age of the pacemaker patients was 73.5 +/- 10.3 years and 64% males, compared to mean age of 68.2 +/- 6.7 years and 67% males in the control group. Overall success of resuscitation and survival rates were similar. When the documented rhythm was VT/VF or asystole there were no differences in resuscitation or survival rates for the pacemaker or nonpacemaker patients. However, resuscitation rate was significantly higher in pacemaker patients than nonpacemaker patients with EMD: 47% versus 20% (P < 0.03). For EMD, survival rate for the pacemaker patients was 13% compared to 5% in the nonpacemaker patients, but this difference was not statistically significant. Backup bradycardia pacing in future generation devices may improve the outcome of non VT/VF sudden cardiac death in at least some of the ICD recipients.

Author List

Thakur RK, Aufderheide TP, Tresch DD, Ghani M

Author

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Arrhythmias, Cardiac
Bradycardia
Death, Sudden, Cardiac
Defibrillators, Implantable
Female
Heart Arrest
Humans
Male
Resuscitation
Survival Rate
Tachycardia, Ventricular
Treatment Outcome
Ventricular Fibrillation