Revue des sciences de la santé

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Abstrait

Cardiovascular outcomes in Dilated Cardiomyopathy patients with and without Implantable Cardioverter Defibrillator

Haripriya K*

Background: Dilated cardiomyopathy (DCM) is an important cause of sudden cardiac death and heart failure. It is characterised by heart chamber dilatation, ventricular systolic dysfunction. There can be different causes for DCM like inherited, infectious and inflammatory diseases. Patients with DCM develop a broad range of Brady arrhythmias and tachyarrhythmias. Some patients could benefit from ICD treatment and demonstrate a significant mortality reduction especially, SCD reduction. Aim: Cardiovascular outcomes in dilated cardiomyopathy patients with and without implantable cardioverter defibrillator.

Methods: This study comprised of 86 patients with DCM who are divided into two groups. group 1 includes those patients with implanted AICD/CRTD and group 2 includes patients with LVEF<45% and without CRTD/AICD ( 43 patients each) .their baseline characteristics were analysed statistically and comparison between the two groups were done and outcomes were obtained.

Results: Most of the patients had severe LV systolic dysfunction on diagnosis as well as on follow up. Higher number of patients belongs to NYHA class 2 prior and after the treatment. The number of patients who had prior hospitalisation for heart failure is much similar within group 1 and 2 (39/43 and33/43 patients respectively).

Events of aborted SCD (VT/VF) were more common within group 1. 19 patients (19/43) in group 1 had appropriate ICD therapy and only a very few patients had events of inappropriate ICD shock. Mortality is similar within group 1 and 2 (16.3% and 14% respectively). The frequency of patients who had SCD is more within group 2 and heart failure related death is more in group 1.

Conclusion: There was a higher number (P=0.008) of patients who succumbed to heart failure related deaths in group 1 (with AICD/CRTD). it is reasonable to assume that the patients in group 1 belonged to a much more advanced heart failure subset. There was a higher number (P=0.008) of patients who had a sudden cardiac death in group 2 (without AICD /CRTD). This is likely due to the fact that the group included only patients without implantable cardioverter defibrillator.