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

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.