Usefulness of the automatic implantable cardioverter defibrillator in improving survival of patients with severely depressed left ventricular function associated with coronary artery disease

Eduardo de Marchena, Simon Chakko, Pedro Fernandez, Augusto Villa, Debbie Cooper, Paula Wozniak, Jose Cruz, Richard J. Thurer, Kenneth M. Kessler, Robert J. Myerburg

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Clinical outcome was analyzed among a group of 39 consecutive patients with coronary artery disease, left ventricular (LV) ejection fractions <30% and arrhythmias that required an automatic implantable cardioverter defibrillator (AICD) in an attempt to better define the role of the device in patients with severely depressed LV function. Twenty-nine (74%) were survivors of out-of-hospital cardiac arrest and 10 (26%) had ventricular tachycardia that was refractory to electrophysiologically guided antiarrhythmic therapy. The study group had the following demographic characteristics: 90% were men, mean age was 64 years (range 41 to 79) and mean LV ejection fraction was 21 ± 4%. Concomitant pharmacotherapy included antiarrhythmic drugs in 31 (79%), vasodilators in 22 (56%) and digoxin in 20 (51%). There was no statistical difference in baseline characteristics between survivors and nonsurvivors. Patients were followed for a mean of 24 months (range 2 to 72) from implantation. The difference between actuarial survival-77% at 1 year and 72% at 2 years-and projected survival without the AICD (patients who survive without appropriate device discharge)-30% at 1 year and 21% at 2 years-was significant (p < 0.01 and <0.05 at 1 and 2 years, respectively). This study suggests that the AICD improves survival in patients with coronary artery disease despite severely depressed LV function.

Original languageEnglish (US)
Pages (from-to)812-816
Number of pages5
JournalThe American Journal of Cardiology
Volume67
Issue number9
DOIs
StatePublished - Apr 15 1991

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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