Implante de desfibrilador como prevención primaria de muerte súbita en pacientes en lista de espera de trasplante cardiaco: experiencia de un centro

Patients who are on a waiting list for cardiac transplantation often have a clinical profile that satisfies current recommendations for the implantation of an implantable cardioverter–defibrillator for the primary prevention of sudden death. The prospect that transplantation may take place within the shortto-medium term puts the effectiveness of this therapy in doubt. We investigated the incidence of therapy delivered by implantable cardioverter–defibrillators implanted for primary prevention in patients awaiting cardiac transplantation. Recent changes in the incidence of sudden death at our center were also investigated. Data on 308 patients listed for heart transplantation between 1998 and 2008 were reviewed. An implantable cardioverter–defibrillator was indicated for primary prevention at initial evaluation in 17 patients. Of these, 53% received appropriate implantable cardioverter–defibrillator therapy while carrying an implantable cardioverter–defibrillator for a mean period of 7.8 months ( 4.8). Only one patient received inappropriate therapy and none had any complications associated with device use. The frequency of sudden death has decreased over the course of recent years.