RESULTS AND EXPERIENCES OF CARDIOVERTER-D EFIBRILLATOR THERAPY AFTER 10 YEARS - OBSERVATIONS IN 353 PATIENTS

Since January 1984, the cardioverter-defibrillator (ICD) has been impl anted in 353 patients (pts). Epicardial ICD implantation was performed in 207 pts and 146 pts underwent non-thoracotomy ICD implant. Overall operative mortality was 3 % (12/353 pts) and was significantly higher in pts with epicardial ICD implantation (11/207 pts, 5 %) than in pat ients who received non-thoracotomy ICDs (1/146 pts, < 1%) (p < 0.05). During a mean follow-up of 25 +/- 23 months, 63 pts (19 %) died: 8 pts (0.8 % per year) from sudden arrhythmic death and 6 pts (0.8 % per ye ar) suddenly without an underlying arrhythmia. Cardiac death was obser ved in 36 pts (4 % per year) and 13 pts (2 % per year) died from other causes. Appropriate ICD discharges were observed in 245 pts (72 %) wi th a mean incidence of 22 +/- 44 IC discharges per pt. In pts with thi rd-generation ICDs, 3,542 ventricular tachyarrhythmias (VTA) were obse rved and terminated by primary ICD shocks in 778 VTA (22 %). Antitachy cardia pacing was attempted in 2,764 VTA (78 %) and was successful in 2,484 VTA (90 %).