Background:During the past two decade implantable cardioverter defibrillator (ICDs) became the mainstay of SCD prevention, resulting in a pronounced increase in the device implantation for primary prevention of sudden cardiac death (SCD). However, currently there are limited data on contemporary rates of appropriate life-saving shock therapy in real life primary prevention population.
Methods: All implants and other ICD operative procedures, nationwide, are entered on line into a computerized secure database. Since its inception in July 2010 3672 new implants were included. Of which, 1192 were implanted for primary prevention. 1605 unselected cases were prospectively followed up for information regarding survival, hospitalizations and ICD therapies over a median follow-up period of one year.
Results: a total of 55 (5%) patients with ICD for primary preventionreceived an appropriate therapy during follow-up, 9 (0.8%) of which were appropriate ICD shock. The rate of arrhythmic events among patients implanted for primary and secondary prevention is presented in Table 1. During follow-up, A total 48 (4%) died, with only a minority (40%) of cardiac causes.
Conclusion: Rates of appropriate shock are lower than previously reported. Most of the patients implanted for primary for primary prevention die due to non cardiac reasons, suggesting a need for contemporary risk stratification approaches prior to device implantation in this population.
