Efficacy Of Implantable Cardioverter Defibrillators In Catecholaminergic Polymorphic Ventricular Tachycardia

Background:Catecholaminergic polymorphic ventricular tachycardia(CPVT)is a hereditary arrhythmia characterized by bidirectional or polymorphic ventricular tachycardia,with high mortality.At present,the preferred treatment is drug therapy,mainly ?-blockers,but the efficacy is not satisfactory.Implantable cardioverter defibrillator(ICD)is a new choice.Although the new guidelines strongly recommend ICD,and cardiac arrest is listed as Class I indications for ICD,but the use of ICD is still controversial.Objective:To conduct a meta-analysis of the incidence of appropriate shock and inappropriate shock after ICD implantation in order to know the efficacy of ICD implantation in CPVT patients.Result:A total of 750 CPVT patients,including clinical and genetic diagnosis,were included in 10 articles.330 patients(44%)received ICD treatment.In CPVT patients receiving ICD,the incidence of appropriate shock to terminate arrhythmia was 35%(95% CI: 24%-47%),and the incidence of inappropriate shock was 23%(95% CI: 15 %-33%).Conclusion:35% of CPVT patients had an appropriate shock to terminate arrhythmia,but 23% of patients received inappropriate shock,and the safety needs to be improved,and electrical storms,infections,machine failures,and equipment replacement make it more difficult for patients to accept.More strict clinical trials and studies are needed to evaluate the efficacy of ICD.