Ocena liczby i adekwatności interwencji, częstości programowania kardiowerterów-defi brylatorów oraz zmian farmakoterapii u pacjentów z kardiomiopatią rozstrzeniową w prewencji pierwotnej nagłego zgonu sercowego

Introduction. Implantation of cardioverter-defibrillator (ICD) is an acknowledged strategy in primary prevention of sudden cardiac death (SCD). The aim of this study was to assess the number and adequacy of ICD interventions and occurrence of modifications of device parameters and pharmacotherapy changes, in patients with dilated cardiomyopathy receiving primary SCD prevention. Material and methods. Retrospective analysis included 138 consecutive patients (123 males, 15 females) with ischaemic (IDCM) and non-ischaemic dilated cardiomyopathy (NIDCM), who underwent ICD implantation. The analysis comprised the number of ventricular tachyarrhythmia episodes, the number and appropriateness of ICD interventions, occurrence of ICD reprogramming and pharmacotherapy changes. Results. ICD interventions occurred in 28% of subjects, pharmacotherapy changes in 27,5% and device parameters modifications in 55,8%. Patient’s age and absence of atrial fibrillation appeared to be significant factors decreasing the risk of ICD interventions. AF presence was connected with high percentage of inadequate interventions. Ventricular arrhythmias presence and device parameters changes appeared to be more frequent in patients with NIDCM than with IDCM. NIDCM appeared to be an independent risk factor for ICD reprogramming. Conclusions. ICD interventions are relatively rare in patients receiving primary SCD prevention. Patient’s age and absence of atrial fibrillation appeared to be significant factors decreasing the risk of ICD interventions. Ventricular arrhythmias presence and device parameters changes appeared to be more frequent in patients with NIDCM than with IDCM.