Outcome of cardioverter-defibrillator implant in patients with arrhythmogenic right ventricular cardiomyopathy.

Abstract	The aim of the present study was to investigate outcomes of implantable cardioverter-defibrillator (ICD) treatment in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). We reviewed baseline/follow-up data of 15 consecutive ARVC patients (mean age 55 +/- 15 years) and 30 randomly drawn patients with coronary artery disease (CAD) (mean age 60 +/- 10 years) with matching durations of follow-up (all implanted with ICDs for primary/secondary prevention of sudden death). At implant, appropriate placement of the RV lead was more difficult in ARVC patients. During follow-up (median 41 months), appropriate interventions for any ventricular tachyarrhythmias occurred in 8 (53%) ARVC patients and 17 (57%) CAD patients, but the occurrence of high rate (>240 beats/min) ventricular tachyarrhythmias was higher in ARVC patients. Inappropriate ICD interventions occurred in 5 (33%) ARVC patients and 10 (33%) CAD patients. Lead-related adverse events requiring surgical revision occurred in 7 (47%) ARVC patients as compared with 4 (13%) CAD patients (P = 0.0004). While ICD implantation is highly effective for prevention of sudden death in ARVC, it does carry elevated burdens of long-term lead-related adverse events. These findings underline the need of careful follow-up in ARVC aimed at early recognition of complications that can impair ICD function.
Authors	Giuseppe Boriani, Paolo Artale, Mauro Biffi, Cristian Martignani, Lorenzo Frabetti, Cinzia Valzania, Igor Diemberger, Matteo Ziacchi, Matteo Bertini, Claudio Rapezzi, Mario Parlapiano, Angelo Branzi
Journal	Heart and vessels (Heart Vessels) Vol. 22 Issue 3 Pg. 184-92 (May 2007) ISSN: 0910-8327 [Print] Japan
PMID	17533523 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References	Anti-Arrhythmia Agents
Topics	Adolescent Adult Aged Anti-Arrhythmia Agents (therapeutic use) Arrhythmogenic Right Ventricular Dysplasia (therapy) Combined Modality Therapy Defibrillators, Implantable (adverse effects) Female Humans Male Middle Aged Survival Rate Treatment Outcome

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