Therapy Modalities with a last generation cardiodefibrilator. A clinical experience

pp 469-474

Abstract

Detection and revertion modalities of the ventricular arrhythmias were analized in 22patients with last generation cardiodefibrilators. The average age was 61.7 years old. The underlying cardiopathy was: chronic coronary 15 patients, dilated myocardiopathy 4, hyperthrophic 1, long QT syndrome 1 and primary electrical disease 1 patient. The ejection fraction was 34.5 % (range 20-81). The prescription for the implant was refractory ventricular tachyarrhythmia in 19 patients and ventricular fibrillation in 3 patients. At least one episode of sudden death successfully reanimated was the main event in 15 of 22 patients. The cardiodefibrillator may be programmed for non-aggressive therapies (antitachycardia pacing and low energy cardioversion); for aggressive ones (high energy shock) and for WI antibradycardia pacemaker. The patients were followed up between 1 and17 months (media8.9).The total mortality was 13.6 % and the surgical one was 9 %, none due to arrhythmia causes. During the follow-up 48 episodes of ventricular fibrillation were detected as well as 765 ventricular tachyarrhythmia with a total of 239 ICD shocks (11.9/patient). The antitachycardia pacing was the most effective method to revert the ventricular tachyarrhythmia, with a success of 82.5%. It was shown that the use of non-aggressive therapies reverted most of the treated arrhythmias, avoiding ICD shocks in this kind of patients with last generation cardiodefibrillators. There were no deaths due to arrhythmic causes, for what it seems these devices have are liable performance.