Outcome Of Implantable Cardioverter Defibrillator Therapy In Hypertrophic Cardiomyopathy: A Meta-analysis

Background: Hypertrophic cardiomyopathy(HCM) with asymmetry as characteristic, have largy influence on patients quality of life.Sudden cardiac death(SCD) is an important cause of death, and the most common cause is ventricular tachycardia, thus timely termination of patients with malignant ventricular arrhythmia can effectively reduce the incidence of SCD. The ICD has recently proved to be a effective therapeutic intervention in patients with malignant ventricular arrhythmia.The ICD recently used to prevent the SCD in patients with HCM. But the number of case is less in single observation, the curative effect and the choice of patients are still not entirely clear. So we need more evidence of Evidence-based medicine(EBM) to prove the therapy efficacy and the incidence of complications of ICD in patients with HCM. Objective:To access the outcome of Implantable Cardioverter Defibrillator(ICD) Therapy in patients with Hypertrophic Cardiomyopathy(HCM). Methods:The relevant studies up to August 2014 were systematically searched through electronic databases(Pub Med, Embase,Wanfang Data,Chinese National Knowledge Infrastructure and Chongqing VIP). The literatures were screened according to the inclusion and exclusion criteria by two reviewers independently. Meta-analyses were performed for pooled results using stata 10.0. Results: A Pub Med database search returned 30 studies on 19 cohorts reporting outcome after ICD therapy in patients with HCM. The publication with the largest number of patients was included in the meta-analysis. ICD interventions, complications, and mortality rates were extracted, pooled, and analyzed. There were 2621 patients. During follow-up, the annualized cardiac mortality rate was 0.6%, the noncardiac mortality rate was 0.8%, and the appropriate ICD intervention rate was 4.1%. The annualized inappropriate ICD intervention rate was 4.9%. Conclusions: This meta-analysis demonstrates a low cardiac and noncardiac mortality rate after ICD therapy in patients with hypertrophic cardiomyopathy. Appropriate ICD intervention was 4.1%/year, most probably preventing SCD.