Cardiovascular Implantable Electronic Devices -> Tachycardia Devices: -> Clinical Trials D-PO06 - Poster Session VI (ID 26) Poster

D-PO06-028 - Ventricular Tachycardia Induction During Electrophysiological Study Predicts Appropriate Therapies In ICD Recipients (ID 1346)

Abstract

Background: Current guidelines recommend ICD implantation for patients with LVEF ≤35% of both ischemic and nonischemic etiology, regardless of the results of the electrophysiological study.
Objective: We aimed to access the value of the EP study in prediction of the arrhythmic events in patients undergoing ICD implantation in the real world setting.
Methods: We compared the risk for all-cause mortality and appropriate therapy according to the results of the EP study of patients who were enrolled and prospectively followed-up in the national ICD registry. The median follow up was 912 days.
Results: Of all patients enrolled in the registry, 246 underwent EP study for primary prevention according to the guidelines and had available long term follow-up. Patients were divided into 2 groups according to the absence or presence of inducible ventricular tachycardia (57 and 189 patients, respectively). Both groups did not differ in the ischemic versus nonischemic etiology, age, sex, hypertension, diabetes mellitus, presence of atrial fibrillation, LVEF, GFR and HB level). Kaplan-Meier survival analysis showed that there was no difference in mortality between the 2 groups (12.3% vs 15.3%, p=0.394). Patients in group 1 were significantly less likely to get any appropriate therapy during the follow-up period (1.8% vs 12.2%, p=0.022). Treatment with either beta blockers or antiarrhythmic drugs at time of implantation had no effect on the incidence of appropriate therapies.
Conclusion: In the real world setting negative EP study predicts very low rate of appropriate ICD therapies during a long follow-up period. The policy of ICD implantation in all patients with LVEF ≤35% might be reconsidered.+
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