A Retrospective Analysis Of VT/VF Episodes Of Implantable Cardioverter Defibrillator Therapies In High-Risk Sudden Cardiac Death Patients

ObjectivesThe purpose of this retrospective,single-center study was to identify the VT/V F episode profile,character and the effectiveness and safety of ATP in implant able cardioverter-defibrillator(ICD)patients,also is to discover optimized ICD p rogramming strategy and management options.MethodsPatients implanted with ICD for the first time in Peking Union Medical College Hospital from January 2006 to December 2017 were included in the study.T hrough outpatient and inpatient records,we collected each clinical profile,ICD programming and VT/VF data.Three experienced electrophysiologists would re view and reevaluate the episode profile and treatment appropriateness of ICD therapies according to the intracardiac electrocardiogram recordings.All result s were analyzed based on categorization by indications.ResultsIn 141 patients included,88 were for primary prevention and 53 were for se condary prevention.During the median follow-up period of 33.3 months,44 p atients experienced 350 VT/VF episodes,among which 300(85.7%)followed b y appropriate therapies and 50(14.3%)followed by inappropriate therapies.In cidence of appropriate therapy(45.2%vs 22.7%,p<0.001)and appropriate sho cks(32.1%vs 10.2%,p<0.001)was higher for secondary prevention patients.People with>2.0 No.of episodes per follow-up year accounted for 33.3% of all appropriate therapy population,with episodes accounted for 72.0%of all e pisodes.However,incidence of inappropriate therapy were similar between groups,with AF/AFL as the most common reason(54.0%)and abnormal sensing as the second(44.0%).Recurrent Primary prevention patients had a higher (FVT+VF)percent(64.5%vs 26.3%,p<0.001),a lower mean CL length(312.1±41.6 vs 359.4±74.1,p<0.001)and a higher percentage of VT CL variability(10.1±1.5 vs 2.9±0.25,p<0.05)than secondary prevention patients.ATP therapy w as effective in 70.6%patients with 2.7%patients accelerated/exacerbated.No difference was found between the two groups of patients in ATP effectiveness and safety.ConclusionPatients implanted for secondary prevention were more likely to receive appro priate therapy and appropriate shocks.Secondary prevention patients seem to have more stable VT events with longer cycle length and this could show an influence on its ATP clinical outcomes.ATP therapy was effective and safe wit h no significant difference between the two groups.VT/VF events were possibl y clustered in 300 events with approprated therapies.