Abstract | INTRODUCTION: METHODS AND RESULTS: Data comprised findings from 310 consecutive patients at a single center who were evaluated and deemed suitable for cardiac transplantation and placed on the waiting list. Kaplan-Meier actuarial approach was used for survival analysis. Survival analysis censored patients at time of transplantation or death. Of the 310 patients, 111 (35.8%) underwent successful cardiac transplantation and 164 (52.9%) died while waiting; 35 patients remain on the waiting list. Fifty-nine (19%) patients had ICD placement for ventricular arrhythmias prior to or after being listed. Twenty-nine (49.1%) ICD patients survived until cardiac transplantation, 13 (22%) patients died, and 17 (28.8%) remain on the waiting list. Among non-ICD patients, 82 (32.7%) received transplants, 151 (60.2%) died, and 18 (7.2%) remain on the waiting list. Survival rates at 6 months and 1, 2, 3, and 4 years were better for all ICD patients compared to non-ICD patients (log-rank x2, P = 0.0001). By multivariate analysis, ICD therapy and beta-blocker treatment were the strongest predictors of survival. Further, ICD treatment was associated with improved survival independent of concomitant treatment with beta-blocker or amiodarone. Among ICD and non-ICD patients treated with a beta-blocker or amiodarone, survivals at the 1 and 4 years were 93% vs 69% and 57% vs 32%, respectively (log-rank x2, P = 0.003). CONCLUSION: ICD therapy is associated with improved survival in high-risk cardiac transplant candidates, and ICD benefit appears to be independent of concomitant treatment.
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Authors | Cengiz Ermis, Gino Zadeii, Alan X Zhu, William Fabian, Joanne Collins, Keith G Lurie, Scott Sakaguchi, David G Benditt |
Journal | Journal of cardiovascular electrophysiology
(J Cardiovasc Electrophysiol)
Vol. 14
Issue 6
Pg. 578-83
(Jun 2003)
ISSN: 1045-3873 [Print] United States |
PMID | 12875416
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Adrenergic beta-Antagonists
- Anti-Arrhythmia Agents
- Amiodarone
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Topics |
- Adrenergic beta-Antagonists
(therapeutic use)
- Adult
- Amiodarone
(therapeutic use)
- Anti-Arrhythmia Agents
(therapeutic use)
- Arrhythmias, Cardiac
(mortality, therapy)
- Cardiomyopathies
(mortality, therapy)
- Combined Modality Therapy
(mortality)
- Defibrillators, Implantable
- Female
- Follow-Up Studies
- Heart Transplantation
(mortality)
- Humans
- Male
- Middle Aged
- Minnesota
- Multivariate Analysis
- Myocardial Ischemia
(mortality, therapy)
- Risk Factors
- Stroke Volume
(physiology)
- Survival Analysis
- Time Factors
- Treatment Outcome
- Waiting Lists
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