LONG-TERM SURVEILLANCE OF THE PATIENTS WITHOUT VERIFIED VENTRICULAR DYSRHYTHMIA TREATED WITH ICD FOR
SECONDARY PREVENTION OF SUDDEN CARDIAC DEATH
S. Misikova, A. Boho, B. Stancak, E. Komanova
Cardiology Clinic, Arrhythmology department, East Slovakia Institute of Cardiovascular diseases, Kosice, Slovakia
Introduction: In clinical practice, there are lots of patients resuscitated for the disturbance of consciousness without satisfactory explanation of cause. Non-hospital conditions do not allow identifying ventricular rhythm disorders all the time. The aim of this study was to analyse the occurrence of ICD therapy in the patients with verified syncope episodes, whereas ventricular dysrhythmia was not confirmed and ICD was implanted.
Methods: : A total of 384 patients with the history of syncope without satisfactory explanation of cause were retrospectively evaluated. All of them underwent electrophysiologic testing (EPT) showing no evidence of sustained ventricular tachycardia. However, the ICD system was implanted in 40 patients.
Results: In 17 patients (42,5%) a minimum of 1 ICD therapy was recorded. There were no ventricular rhythm disorders observed in the remaining 23 patients. The negative predictive value of EPT was 57,5%.
Conclusions: The decision about the requirement of the ICD implantation in the patients with unsolved syncope episodes has to rely on clinical facts. Regarding this, it is possible to predict the origin of the syncope and begin with the best treatment strategy.
|
|
Patients with ICD therapy (n = 17)
|
Patients without ICD therapy(n = 23)
|
| Age (years) |
Period to 1. ICD therapy (months) |
Age (years) |
Period of follow up (months) |
| Mean ± SD |
47 ± 20 |
15 ± 18 |
60 ± 11 |
32 ± 13 |
| Median (IQR) |
55 (18-74) |
9 (1-72) |
61 (43-82) |
34 (1-52) |
