INFLUENCE OF PATIENT CHARACTERISTICS IN THE SELECTION OF PATIENTS FORDEFIBRILLATOR IMPLANTATION (THE AVID REGISTRY)

The Antiarrhythmics versus Implantable Defibrillators (AVID) trial is a prospective, randomized study of treatment for life-threatening vent ricular arrhythmias. Patients who are eligible for the main trial hut who are not enrolled for any reason are followed in a registry. The ob jective of the present study was to determine whether there are identi fiable patient characteristics among these registry patients that may influence whether a patient is treated with an implantable defibrillat or. The 914 patients in the registry were divided into 2 groups accord ing to whether the primary treatment wets an implantable defibrillator . The mean age of defibrillator patients was 60 years, compared with 6 5 years in the nondefibrillator group (p <0.001). Only 11.2% of defibr illator recipients were minorities, whereas the percentage of minoriti es in the nondefibrillator group was 18.7% (p <0.003). A history of re current ventricular fibrillation was more likely-in the group treated with defibrillators (8.9% vs 4.4%, p <0.01), whereas a history of atri al fibrillation or diabetes mellitus were both significantly more like ly in the nondefibriilator group. Among defibrillator patients, a high er proportion had ventricular fibrillation as the index arrhythmia; pa tients with ventricular tachycardia were significantly more likely to be treated without devices. In this prospective hut nonrandomized coho rt of patients treated for life-threatening ventricular arrhythmias, o lder age, minority status, and comorbidity reduced the chances that a patient would be treated with a defibrillator. (C) 1997 by Excerpta Me dica, Inc.