Implantable Cardioverter-Defibrillator of Korean Patients in a Single Center Registry

Hwang, Jin Kyung; Gwag, Hye Bin; Park, Seung Jung; Park, Kyoung Min; Kim, June Soo; On, Young Keun

Abstract

BACKGROUND AND OBJECTIVES
The safety and efficacy of implantable cardioverter-defibrillator (ICD) for Korean is unclear. We investigated the clinical characteristics and outcomes of Korean patients undergoing ICD for primary or secondary prevention.
MATERIALS AND METHODS
From October 1999 to December 2016, 396 cases (365 patients) of ICD implantation were performed: Baseline characteristics, procedural findings, and clinical outcome data were collected retrospectively from our ICD registry. The primary outcome was composite of cardiac death, appropriate shock or antitachycardia pacing.
RESULTS
Among 365 patients, 91 patients (25.9%) had ICD for primary prevention and 274 patients (75.1%) were for secondary prevention (51.2±17.10 years, male was 80.8%). The median follow-up period was 3.1 years (interquartile range: 1.6-6.0 days). The most prevalent etiology was dilated cardiomyopathy (46.2%) in the primary prevention and idiopathic ventricular tachycardia or fibrillation (24.4%) in the secondary prevention. The primary outcome was noted in 28.6% of the primary prevention and 33.2% of the secondary prevention (P=0.44). The rate of cardiac death was 2.2% in the primary prevention and 1.8% in the secondary prevention (P=1.00). The hospitalization due to heart failure was higher in the primary prevention compared with the secondary prevention (23.1% versus 13.5%, P=0.03). ICD therapy occurred in 134 patients (36.7%). Among them, 60 patients (44.8% of ICD therapy) experienced inappropriate shock. The most common cause of inappropriate shock was atrial fibrillation of flutter (AF/AFL).
CONCLUSION
The clinical efficacy and safety of ICD in Korean is consistent with the data from Western countries.