Global Study Compares ICD Implantation Rates in HCM; Assesses Patient Outcomes

While implantations of implantable cardioverter defibrillator (ICD) for primary prevention of sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy were more frequent in the U.S. vs. other countries, there was no significant difference in SCD rates in U.S. vs. non-U.S. patients who did not receive an ICD, according to new research published in the European Heart Journal.

Researchers assessed 5,310 patients with HCM from eight U.S. sites (n=2,650) and five non-U.S. sites (n=2,660) and used multivariable Cox-proportional hazards models to compare outcomes. Overall results found primary prevention ICD implantation rates in U.S. sites were two-fold higher than non-U.S. sites, including in individuals deemed at high risk.

Victor Nauffal, MD, et al., also noted rates of appropriate ICD therapy among ICD patients were significantly lower in U.S. vs. non-U.S. sites, while no significant difference was identified in the incidence of SCD/resuscitated cardiac arrest among non-recipients of ICDs in U.S. vs. non-U.S. sites.

Based on their findings, Nauffal and colleagues note that “further studies are needed to understand what drives malignant arrhythmias, optimize ICD allocation, and examine the impact of different ICD utilization strategies on long-term outcomes in HCM.”

Clinical Topics: Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: Primary Prevention, Arrhythmias, Cardiac, Cardiomyopathy, Hypertrophic, Proportional Hazards Models, Defibrillators, Implantable, ACC International


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