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Outcome of cardioverter–defibrillator implant in patients with arrhythmogenic right ventricular cardiomyopathy

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Abstract

The aim of the present study was to investigate outcomes of implantable cardioverter–defibrillator (ICD) treatment in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). We reviewed baseline/follow-up data of 15 consecutive ARVC patients (mean age 55 ± 15 years) and 30 randomly drawn patients with coronary artery disease (CAD) (mean age 60 ± 10 years) with matching durations of follow-up (all implanted with ICDs for primary/secondary prevention of sudden death). At implant, appropriate placement of the RV lead was more difficult in ARVC patients. During follow-up (median 41 months), appropriate interventions for any ventricular tachyarrhythmias occurred in 8 (53%) ARVC patients and 17 (57%) CAD patients, but the occurrence of high rate (>240 beats/min) ventricular tachyarrhythmias was higher in ARVC patients. Inappropriate ICD interventions occurred in 5 (33%) ARVC patients and 10 (33%) CAD patients. Lead-related adverse events requiring surgical revision occurred in 7 (47%) ARVC patients as compared with 4 (13%) CAD patients (P = 0.0004). While ICD implantation is highly effective for prevention of sudden death in ARVC, it does carry elevated burdens of long-term lead-related adverse events. These findings underline the need of careful follow-up in ARVC aimed at early recognition of complications that can impair ICD function.

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Authors and Affiliations

  1. Istituto di Cardiologia, Università di Bologna, Policlinico S. Orsola-Malpighi, via Massarenti 9, 40138, Bologna, Italy

    Giuseppe Boriani, Paolo Artale, Mauro Biffi, Cristian Martignani, Lorenzo Frabetti, Cinzia Valzania, Igor Diemberger, Matteo Ziacchi, Matteo Bertini, Claudio Rapezzi & Angelo Branzi

  2. Divisione di Cardiochirurgia, Università di Bologna, Azienda Ospedaliera S. Orsola-Malpighi, Bologna, Italy

    Mario Parlapiano

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  1. Giuseppe Boriani
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  2. Paolo Artale
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  3. Mauro Biffi
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  4. Cristian Martignani
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  12. Angelo Branzi
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Correspondence to Giuseppe Boriani.

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Boriani, G., Artale, P., Biffi, M. et al. Outcome of cardioverter–defibrillator implant in patients with arrhythmogenic right ventricular cardiomyopathy. Heart Vessels 22, 184–192 (2007). https://doi.org/10.1007/s00380-006-0963-8

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