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See Latest ArticlesThe efficacy of implantable cardioverter-defibrillators in heart transplant recipients: Results from a multicenter registry
Circulation: Heart Failure, 05/04/09
Tsai VW et al. – Use of implantable cardioverter-defibrillators (ICDs) following heart transplantation may be appropriate in select high risk pts. Further studies must establish an appropriate prevention strategy in this population.
Methods- Study of whether ICDs are effective in preventing sudden cardiac death (SCD) in high-risk heart transplant recipients
- Retrospective analysis of records of all orthotopic heart transplant (OHT) pts who had ICD implantation January 1995-December 2005 at 5 heart transplant centers
- High risk for SCD in 36 pts
- Mean age at OHT: 44±14 yrs; most pts male (29)
- Mean age at ICD implantation: 52±14 yrs
- Average time from OHT to ICD implant: 8 ±6 yrs
- Main indications for ICD implantation: severe allograft vasculopathy (12 pts), unexplained syncope (9), history of cardiac arrest (8), and severe left ventricular dysfunction (7)
- Of 22 shocks for 10 pts (28%), 12 appropriate shocks for 8 (80%) for either rapid ventricular tachycardia or ventricular fibrillation
- Shocks effective in terminating ventricular arrhythmias in all cases
- Inappropriate shocks (10) for 3 (8%) pts
- Underlying allograft vasculopathy in 100% (8/8) of pts who received appropriate ICD therapy
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