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2022, Number 4

Cardiovasc Metab Sci 2022; 33 (4)

Factors associated with the survival of patients with implanted cardiac defibrillators in a cohort from Medellin, Colombia

Sotelo-Narváez, Jorge Enrique; Ruiz-Velásquez, Luis Miguel; Aristizábal-Aristizábal, Julián Miguel; Marín-Velásquez, Jorge Eduardo; Díaz-Martínez, Juan Carlos

ABSTRACT

Introduction: sudden cardiac death accounts for 50% of cardiovascular deaths worldwide and 20% of mortality. The use of an implantable cardioverter defibrillator (ICD) is associated with the optimal management of cardiovascular diseases and positively impacts mortality. Material and methods: a retrospective cohort of 730 patients required an ICD and attended electrophysiology consultation in eight hospitals in Medellín, Colombia, between 2013 and 2020 and had a follow-up for at least six months with two controls. Adjusted and survival analyzes were performed. Results: 72% of patients were male. The most prevalent pathologies were arterial hypertension (71%) and dyslipidemia (46%). 56.7% of patients had ischemic heart disease. At the beginning of the follow-up, 72.9% had an ejection fraction (LVEF) of less than 35%, and echocardiographic follow-up found improvement in LVEF, less than 35% in 19.9%. 62.7% had an ICD for primary prevention, 20.3% received appropriate therapy due to ventricular tachycardia, and 11.2% and 14.7% had inappropriate therapy, usually caused by atrial fibrillation (8.5%). Survival analysis found that functional class NYHA III (HR 2.96, 95% CI 1.85-5.15), arterial hypertension (HR 2.182, 95% CI 1.23-3.86), inappropriate therapies, and age (HR 1.02, 95% CI 1.01-1.03) were associated with a significant decrease in survival in patients with an ICD. Conclusion: in this study, it was found that most of the patients were men, and the main indication of ICD was primary prevention. Age, NYHA III functional class, arterial hypertension, and inappropriate therapies were associated with a significant decrease in survival in patients with an ICD.
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Keywords

sudden cardiac death implantable cardioverter defibrillators cardiac pacing devices




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Cardiovascular and Metabolic Science Vol. 33, Num. 4, Octubre-Diciembre 2022. Es una publicación trimestral editada por la Asociación Nacional de Cardiólogos de México. Magdalena 135. Col. Del Valle. Del. Benito Juárez. Ciudad de México, México. C.P. 03103. Tel. 5556368002 https://www.cardiovascularandmetabolicscience.org.mx/ ancam@ancam.org.mx https://www.medigraphic.com/cms/ E-mail addresses: revmexcardiol@gmail.com Editor responsable. Dr. Eduardo Meaney Mendiolea. Reserva de Derechos al Uso Exclusivo Nº 04-2019-061316491900-203. ISSN: 2683-2828 versión impresa y 2954-3835 versión electrónica. Ambos otorgados por el Instituto Nacional del Derecho de Autor. Responsable de la última actualización de este número, Departamento de Internet, Graphimedic, S.A. de C.V., Ing. Luis Rosales Jiménez, Coquimbo 936, Col. Lindavista, Delegación Gustavo A. Madero, C.P. 07300, Ciudad de México, México. Fecha de última modificación, 04 de abril de 2024.

 

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