Distinct Clinical Features in the Recipients of the Implantable Cardioverter Defibrillator in Taiwan: A Multicenter Registry Study

Chia Ti Tsai, Shoei K. Stephen Huang, Jiunn Lee Lin, Ling Ping Lai

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Little information about the ICD is available from the Asian Pacific region. The purpose of this study was to characterize the clinical features in ICD patients in Taiwan and to compare these features with those in patients in the Western populations, mainly the Canadian Implantable Defibrillator Study (CIDS), the Antiarrhythmics versus Implantable Defibrillator (AVID) trial, and the Cardiac Arrest Study Hamburg (CASH) trial. From February 1995 to October 2001, 101 ICDs were implanted in 92 patients (78 [84%] men) in 12 hospitals. Clinical presentations included sudden cardiac death due to VF/VT in 35 (38%) patients, syncopal VT in 25 (27%), drug refractory nonsyncopal VT in 27 (29%), and unexplained syncope with inducible sustained VT/VF in 5 (6%). The mean age was significantly younger than that in CIDS or AVID (59 ± 16 vs 63 ± 9 years in CIDS, P = 0.02; vs 65 ± 11 years in AVID, P < 0.001), but was comparable to that in CASH (59 ± 16 vs 58 ± 11 years in CASH, P = 0.75). The mean LVEF was significantly higher than that in CIDS or AVID (48 ± 19% vs 34 ± 15% in CIDS, P < 0.002; vs 32 ± 13% in AVID, P < 0.001), but was comparable to that in CASH (48 ± 19 vs 46 ± 19% in CIDS, P = 0.83). The ICD patients in the current study also showed a higher incidence of normal heart (23 vs 4% in CIDS, P < 0.001; vs 3% in AVID, P < 0.001; vs 9% in CASH, P < 0.001) and cardiomyopathy (41 % vs 10% in CIDS, P < 0.001; vs 15% in AVID, P < 0. 001; vs 11% in CASH, P < 0.001), but a lower incidence of coronary artery disease (29% vs 83% in CIDS, P < 0.001; vs 82% in AVID, P < 0.001; vs 73% in CASH, P < 0.001). During a mean follow-up of 28 ± 24 months, 13 (14%) patients died. Older age was the only factor associated with poorer survival after ICD implantation. Forty-seven (51%) patients received appropriate ICD discharges during follow-up. History of prior myocardial infarction was the only factor associated with an earlier first appropriate ICD discharge and LVEF < 0.35 the only factor associated with subsequent poorer survival after the first ICD discharge. In conclusion, this study demonstrated many distinct clinical features in our ICD population that were different from those in the Western populations.

Original languageEnglish
Pages (from-to)2083-2090
Number of pages8
JournalPACE - Pacing and Clinical Electrophysiology
Volume26
Issue number11
DOIs
Publication statusPublished - Nov 1 2003
Externally publishedYes

Keywords

  • Implantable cardioverter defibrillator
  • Sudden cardiac death
  • Ventricular tachyarrhythmias

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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