EARLY BENEFIT OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR THERAPY IN PATIENTS WAITING FOR CARDIAC TRANSPLANTATION

The ICD can effectively recognize and treat ventricular arrhythmias th at can lead to sudden death. Sudden death is a major problem in patien ts awaiting heart transplantation. We reviewed our experience with the ICD in patients with malignant ventricular arrhythmias waiting for ca rdiac transplantation. Nineteen patients were included. Seventeen were men, mean age was 54 +/- 11 years (range 17-66) and the left ventricu lar ejection fraction was 22% +/- 10% (range 9%-46%). After a mean fol low-up of 6 +/- 5 months (range 1-20 months), 17 patients reached hear t transplantation. One patient died and the other is waiting for a tra nsplant. Before transplantation 71% of patients received an appropriat e discharge. The mean time to the first appropriate discharge was 2 +/ - 2 months (range < 1-6 months), which was significantly shorter than the mean time to first discharge in the other patients (n = 182) recei ving a defibrillator in our center (11 +/- 10 months; range 1-58 month s) (P < 0.0004). In conclusion, cardiac transplantation candidates wit h life-threatening ventricular arrhythmias can effectively be protecte d against sudden arrhythmic death by ICD. These patients have a high i ncidence of appropriate shocks occurring very early after implantation .