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Outcome of patients with nonischemic dilated cardiomyopathy and unexplained syncope treated with an implantable defibrillator.

Abstract：

OBJECTIVES:The purpose of this study was to determine the outcome of patients with nonischemic dilated cardiomyopathy, unexplained syncope and a negative electrophysiology test who are treated with an implantable defibrillator. BACKGROUND:Patients with nonischemic cardiomyopathy and unexplained syncope may be at high risk for sudden cardiac death, and they are sometimes treated with an implantable defibrillator. METHODS:This study prospectively determined the outcome of 14 consecutive patients who had a nonischemic cardiomyopathy, unexplained syncope and a negative electrophysiology test and who underwent defibrillator implantation (Syncope Group). Nineteen consecutive patients with a nonischemic cardiomyopathy and a cardiac arrest who were treated with a defibrillator (Arrest Group) served as a control group. RESULTS:Seven of 14 patients (50%) in the Syncope Group received appropriate shocks for ventricular arrhythmias during a mean follow-up of 24+/-13 months, compared with 8 of 19 patients (42%) in the Arrest Group during a mean follow-up of 45+/-40 months (p = 0.1). The mean duration from device implantation until the first appropriate shock was 32+/-7 months (95% confidence interval [CI], 18 to 45 months) in the Syncope Group compared to 72+/-12 months (95% CI, 48 to 96 months) in the Arrest Group (p = 0.1). Among patients who received appropriate shocks, the mean time from defibrillator implantation to the first appropriate shock was 10+/-14 months in the Syncope Group, compared with 48+/-47 months in the Arrest Group (p = 0.06). Recurrent syncope was always associated with ventricular tachyarrhythmias. CONCLUSIONS:The high incidence of appropriate defibrillator shocks and the association of recurrent syncope with ventricular arrhythmias support the treatment of patients with nonischemic cardiomyopathy, unexplained syncope and a negative electrophysiology test with an implantable defibrillator.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Knight BP,Goyal R,Pelosi F,Flemming M,Horwood L,Morady F,Strickberger SA

doi

10.1016/s0735-1097(99)00148-5

subject

Has Abstract

pub_date

1999-06-01 00:00:00

pages

1964-70

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(99)00148-5

journal_volume

pub_type

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Outcome of patients with nonischemic dilated cardiomyopathy and unexplained syncope treated with an implantable defibrillator.