Primary Prevention of Sudden Cardiac Death With Implantable Cardioverter-Defibrillator Therapy in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy

Pyotr G. Platonov; Kristina H. Haugaa; Henning Bundgaard; Anneli Svensson; Thomas Gilljam; Jim Hansen; Trine Madsen; Anders Gaarsdal Holst; Jonas Carlson; Øyvind H. Lie; Morten Kvistholm Jensen; Thor Edvardsen; Henrik K. Jensen; Jesper H. Svendsen

doi:10.1016/j.amjcard.2018.12.049

Primary Prevention of Sudden Cardiac Death With Implantable Cardioverter-Defibrillator Therapy in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy

Pyotr G. Platonov^*, Kristina H. Haugaa, Henning Bundgaard, Anneli Svensson, Thomas Gilljam, Jim Hansen, Trine Madsen, Anders Gaarsdal Holst, Jonas Carlson, Øyvind H. Lie, Morten Kvistholm Jensen, Thor Edvardsen, Henrik K. Jensen, Jesper H. Svendsen

^*Corresponding author for this work

Department of Clinical Medicine

3 Citations (Scopus)

Abstract

Implantable cardioverter-defibrillator (ICD) therapy remains a corner stone of sudden cardiac death (SCD) prevention in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed to assess predictors of appropriate ICD therapies in the Scandinavian cohort of ARVC patients who received ICD for primary prevention of SCD. Study group comprised of 79 definite ARVC patients by 2010 Task Force criteria (60% male, age at ICD implant 39 ± 14 years) who were enrolled in the Nordic ARVC Registry and received an ICD for primary SCD prevention. The primary end point of appropriate ICD shock or death from any cause was assessed and compared with 137 definite ARVC patients who received ICD for secondary SCD prevention (74% male, age at ICD implant 42 ± 15 years). In the study group, 38% were ≤35 years of age at baseline, 25% had nonsustained ventricular tachycardia, and 29% had syncope at baseline. Major repolarization abnormality (hazard ratio = 4.00, 95% confidence interval 1.30 to 12.30, p = 0.015) and age ≤35 years (hazard ratio = 4.21, 95% confidence interval 1.49 to 11.85, p = 0.001) independently predicted the primary end point. The outcome did not differ between the primary prevention patients with either of these risk factors and the secondary prevention cohort (2% to 4% annual event rate) whereas patients without risk factors did not have any appropriate ICD shocks during follow-up. In conclusion, young age at ARVC diagnosis and major repolarization abnormality independently predict ICD shocks or death in the primary prevention ICD recipients and associated with the event rate similar to the one observed in the secondary prevention cohort. Our data indicate the benefit of ICD for primary prevention in patients with any of these risk factors.

Original language	English
Journal	American Journal of Cardiology
Volume	123
Issue number	7
Pages (from-to)	1156-1162
Number of pages	7
ISSN	0002-9149
DOIs	https://doi.org/10.1016/j.amjcard.2018.12.049
Publication status	Published - 2019

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10.1016/j.amjcard.2018.12.049

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Platonov, P. G., Haugaa, K. H., Bundgaard, H., Svensson, A., Gilljam, T., Hansen, J., Madsen, T., Holst, A. G., Carlson, J., Lie, Ø. H., Kvistholm Jensen, M., Edvardsen, T., Jensen, H. K., & Svendsen, J. H. (2019). Primary Prevention of Sudden Cardiac Death With Implantable Cardioverter-Defibrillator Therapy in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy. American Journal of Cardiology, 123(7), 1156-1162. https://doi.org/10.1016/j.amjcard.2018.12.049

Primary Prevention of Sudden Cardiac Death With Implantable Cardioverter-Defibrillator Therapy in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy. / Platonov, Pyotr G.; Haugaa, Kristina H.; Bundgaard, Henning et al.

In: American Journal of Cardiology, Vol. 123, No. 7, 2019, p. 1156-1162.

Research output: Contribution to journal › Journal article › Research › peer-review

Platonov, PG, Haugaa, KH, Bundgaard, H, Svensson, A, Gilljam, T, Hansen, J, Madsen, T, Holst, AG, Carlson, J, Lie, ØH, Kvistholm Jensen, M, Edvardsen, T, Jensen, HK & Svendsen, JH 2019, 'Primary Prevention of Sudden Cardiac Death With Implantable Cardioverter-Defibrillator Therapy in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy', American Journal of Cardiology, vol. 123, no. 7, pp. 1156-1162. https://doi.org/10.1016/j.amjcard.2018.12.049

@article{f58580b4d5e6442c9f2079ec14a60a6f,

title = "Primary Prevention of Sudden Cardiac Death With Implantable Cardioverter-Defibrillator Therapy in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy",

abstract = "Implantable cardioverter-defibrillator (ICD) therapy remains a corner stone of sudden cardiac death (SCD) prevention in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed to assess predictors of appropriate ICD therapies in the Scandinavian cohort of ARVC patients who received ICD for primary prevention of SCD. Study group comprised of 79 definite ARVC patients by 2010 Task Force criteria (60% male, age at ICD implant 39 ± 14 years) who were enrolled in the Nordic ARVC Registry and received an ICD for primary SCD prevention. The primary end point of appropriate ICD shock or death from any cause was assessed and compared with 137 definite ARVC patients who received ICD for secondary SCD prevention (74% male, age at ICD implant 42 ± 15 years). In the study group, 38% were ≤35 years of age at baseline, 25% had nonsustained ventricular tachycardia, and 29% had syncope at baseline. Major repolarization abnormality (hazard ratio = 4.00, 95% confidence interval 1.30 to 12.30, p = 0.015) and age ≤35 years (hazard ratio = 4.21, 95% confidence interval 1.49 to 11.85, p = 0.001) independently predicted the primary end point. The outcome did not differ between the primary prevention patients with either of these risk factors and the secondary prevention cohort (2% to 4% annual event rate) whereas patients without risk factors did not have any appropriate ICD shocks during follow-up. In conclusion, young age at ARVC diagnosis and major repolarization abnormality independently predict ICD shocks or death in the primary prevention ICD recipients and associated with the event rate similar to the one observed in the secondary prevention cohort. Our data indicate the benefit of ICD for primary prevention in patients with any of these risk factors.",

author = "Platonov, {Pyotr G.} and Haugaa, {Kristina H.} and Henning Bundgaard and Anneli Svensson and Thomas Gilljam and Jim Hansen and Trine Madsen and Holst, {Anders Gaarsdal} and Jonas Carlson and Lie, {{\O}yvind H.} and {Kvistholm Jensen}, Morten and Thor Edvardsen and Jensen, {Henrik K.} and Svendsen, {Jesper H.}",

year = "2019",

doi = "10.1016/j.amjcard.2018.12.049",

language = "English",

volume = "123",

pages = "1156--1162",

journal = "Am. J. Cardiol.",

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T1 - Primary Prevention of Sudden Cardiac Death With Implantable Cardioverter-Defibrillator Therapy in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy

AU - Platonov, Pyotr G.

AU - Haugaa, Kristina H.

AU - Bundgaard, Henning

AU - Svensson, Anneli

AU - Gilljam, Thomas

AU - Hansen, Jim

AU - Madsen, Trine

AU - Holst, Anders Gaarsdal

AU - Carlson, Jonas

AU - Lie, Øyvind H.

AU - Kvistholm Jensen, Morten

AU - Edvardsen, Thor

AU - Jensen, Henrik K.

AU - Svendsen, Jesper H.

PY - 2019

Y1 - 2019

N2 - Implantable cardioverter-defibrillator (ICD) therapy remains a corner stone of sudden cardiac death (SCD) prevention in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed to assess predictors of appropriate ICD therapies in the Scandinavian cohort of ARVC patients who received ICD for primary prevention of SCD. Study group comprised of 79 definite ARVC patients by 2010 Task Force criteria (60% male, age at ICD implant 39 ± 14 years) who were enrolled in the Nordic ARVC Registry and received an ICD for primary SCD prevention. The primary end point of appropriate ICD shock or death from any cause was assessed and compared with 137 definite ARVC patients who received ICD for secondary SCD prevention (74% male, age at ICD implant 42 ± 15 years). In the study group, 38% were ≤35 years of age at baseline, 25% had nonsustained ventricular tachycardia, and 29% had syncope at baseline. Major repolarization abnormality (hazard ratio = 4.00, 95% confidence interval 1.30 to 12.30, p = 0.015) and age ≤35 years (hazard ratio = 4.21, 95% confidence interval 1.49 to 11.85, p = 0.001) independently predicted the primary end point. The outcome did not differ between the primary prevention patients with either of these risk factors and the secondary prevention cohort (2% to 4% annual event rate) whereas patients without risk factors did not have any appropriate ICD shocks during follow-up. In conclusion, young age at ARVC diagnosis and major repolarization abnormality independently predict ICD shocks or death in the primary prevention ICD recipients and associated with the event rate similar to the one observed in the secondary prevention cohort. Our data indicate the benefit of ICD for primary prevention in patients with any of these risk factors.

AB - Implantable cardioverter-defibrillator (ICD) therapy remains a corner stone of sudden cardiac death (SCD) prevention in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed to assess predictors of appropriate ICD therapies in the Scandinavian cohort of ARVC patients who received ICD for primary prevention of SCD. Study group comprised of 79 definite ARVC patients by 2010 Task Force criteria (60% male, age at ICD implant 39 ± 14 years) who were enrolled in the Nordic ARVC Registry and received an ICD for primary SCD prevention. The primary end point of appropriate ICD shock or death from any cause was assessed and compared with 137 definite ARVC patients who received ICD for secondary SCD prevention (74% male, age at ICD implant 42 ± 15 years). In the study group, 38% were ≤35 years of age at baseline, 25% had nonsustained ventricular tachycardia, and 29% had syncope at baseline. Major repolarization abnormality (hazard ratio = 4.00, 95% confidence interval 1.30 to 12.30, p = 0.015) and age ≤35 years (hazard ratio = 4.21, 95% confidence interval 1.49 to 11.85, p = 0.001) independently predicted the primary end point. The outcome did not differ between the primary prevention patients with either of these risk factors and the secondary prevention cohort (2% to 4% annual event rate) whereas patients without risk factors did not have any appropriate ICD shocks during follow-up. In conclusion, young age at ARVC diagnosis and major repolarization abnormality independently predict ICD shocks or death in the primary prevention ICD recipients and associated with the event rate similar to the one observed in the secondary prevention cohort. Our data indicate the benefit of ICD for primary prevention in patients with any of these risk factors.

U2 - 10.1016/j.amjcard.2018.12.049

DO - 10.1016/j.amjcard.2018.12.049

M3 - Journal article

C2 - 30678832

AN - SCOPUS:85060219809

SN - 0002-9149

VL - 123

SP - 1156

EP - 1162

JO - Am. J. Cardiol.

JF - Am. J. Cardiol.

IS - 7

ER -

Primary Prevention of Sudden Cardiac Death With Implantable Cardioverter-Defibrillator Therapy in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy

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