Implantable cardioverter/defibrillator interventions in primary prevention: do current implantation criteria really predict ICD interventions?

Background Randomized controlled trials have proven the effi cacy of implantable cardioverter/defi brillators (ICDs) to prevent sudden cardiac death (SCD) in primary prevention. However, long-term data on the incidence of appropriate and inappropriate interventions in real life and on the predictive value of commonly used clinical variables to guide patient selection are scarce.Methods We retrospectively studied 101 patients who received an ICD for primary prophylaxis of SCD: 63.4% with ischaemic heart disease (IHD) and 36.6% with idiopathic dilated cardiomyopathy (IDCM). The mean follow-up period was 26.2 (± 14.8; median 27.8; range 5.6-70.5) months. Age, left ventricular ejection fraction (LVEF), QRS duration, NYHA class and electrophysiological study (EPS) outcome were evaluated as predictors of ICD intervention.Results At 2 years the cumulative incidence of appropriate (17.5% in IHD; 28% in IDCM; P= 0.63) and inappropriate (12.8% in IHD, 15.4% in IDCM; P= 0.62) interventions was similar in both groups...