Preventive effectiveness of implantable cardioverter defibrillator in reducing sudden cardiac death in the Chinese population: a multicenter trial of ICD therapy versus non-ICD therapy

J Cardiovasc Electrophysiol. 2012 Nov:23 Suppl 1:S5-9. doi: 10.1111/j.1540-8167.2012.02435.x.

Abstract

Preventive Effectiveness of Implantable Cardioverter.

Introduction: This prospective and multicenter trial of the implantable cardioverter-defibrillator (ICD) aimed to evaluate the mortality rate (including sudden cardiac death [SCD]) and the efficacy of ICD in Chinese patients with high risk of sudden death.

Methods and results: This trial was conducted in 31 centers in China. We enrolled 497 patients who fulfilled Class I indication for ICD (2002 ACC/AHA/NASPE guideline). All patients were followed-up at 3, 6, and 12 months. Clinical characteristics and echocardiographic parameters were collected at baseline and follow-up; Kaplan-Meier survival analysis was performed. Among 497 enrolled patients with Class I indication of ICD therapy, 112 (22.5%) agreed to and received ICD implantation (ICD group). The remaining 385 patients who were not available for ICD therapy were designated as the non-ICD group. During a mean follow-up of 11 ± 3 months, there were a total of 38 deaths, 2 in the ICD group with a mortality of 1.8% and 36 in the non-ICD group, with a mortality of 9.4% and 26 due to SCD. The overall survival rate was 93% at 3 months of follow-up, 91% at 6 months, and 89% at 12 months, with an incidence of SCD of 5%, 7%, and 8% at 3, 6, and 12 months, respectively.

Conclusions: In patients with Class I indication of ICD implantation, the total mortality and incidence of SCD were high. ICD therapy can effectively reduce the mortality in such patients.

Publication types

  • Comparative Study
  • Controlled Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Chi-Square Distribution
  • China / epidemiology
  • Death, Sudden, Cardiac / epidemiology
  • Death, Sudden, Cardiac / prevention & control*
  • Defibrillators, Implantable*
  • Electric Countershock / adverse effects
  • Electric Countershock / instrumentation*
  • Electric Countershock / mortality
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Prospective Studies
  • Prosthesis Design
  • Risk Factors
  • Tachycardia, Ventricular / diagnosis
  • Tachycardia, Ventricular / mortality
  • Tachycardia, Ventricular / therapy*
  • Time Factors
  • Treatment Outcome
  • Ventricular Fibrillation / diagnosis
  • Ventricular Fibrillation / mortality
  • Ventricular Fibrillation / therapy*