Competing Risks for Ventricular Tachyarrhythmias Prior to Death in Patients with Severely Impaired Renal Function with an Implantable Defibrillator

Background: Heart failure patients with advanced kidney disease (KD) may experience an increased rate of non-arrhythmic mortality due to associated comorbidities. We aimed to evaluate the competing risks between arrhythmic events and death in this high-risk population.

Methods: The study population comprised 3,542 patients who received an ICD for primary prevention and were enrolled and prospectively followed-up in the Israeli ICD registry. Study patients were categorized into two groups by the presence of advanced kidney disease: those with advanced KD, defined by a glomerular filtration rate (GFR) of

Results: Patients with advanced KD had higher rates of comorbidities. They were older with more advanced heart failure symptoms. Kaplan-Meier survival analysis showed that at 5-years of follow-up the rates of death without prior ICD shock were significantly higher in the advanced kidney disease group (46%) compared to the non-advanced KD group (19%) [log-rank P-value

Conclusion: ICD recipients for primary prevention with advanced KD (eGFR