SURVIVAL AFTER IMPLANTATION OF THE CARDIOVERTER DEFIBRILLATOR

The actuarial survival of 60 consecutive recipients of the implanted c ardioverter defibrillator (ICD) were compared with 120 matched concurr ent medically treated patients using a case-control design. All ICD pa tients and controls presented with either sustained ventricular tachyc ardia or ventricular fibrillation. Controls were matched to ICD recipi ents according to 5 variables: age, left ventricular ejection fraction , arrhythmia at presentation, underlying heart disease and drug therap y status. Mean ages were 58 and 59 years in ICD patients and controls, and the average ejection fractions were 36 and 35%. Coronary artery d isease was present in 75 and 79% of ICD patients and controls, respect ively. During follow-up, sudden deaths were fewer in ICD recipients th an in controls (5 vs 10%, p < 0.01). At 1 and 3 years, actuarial survi val was 0.89 vs 0.72 and 0.65 vs 0.49 for ICD recipients and controls. The 5-year actuarial survival curves were significantly different by the Cox proportional hazards model (p < 0.05). It is concluded that in this retrospective case-control study, the use of the ICD in the mana gement of patients at risk for sudden death results in improved probab ility of survival.