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Implantable cardioverter defibrillators in patients with electrical heart disease and hypertrophic cardiomyopathy: data from the German device registry

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Abstract

Background

Implantable cardioverter- defibrillator (ICD) therapy is established for the prevention of sudden cardiac death (SCD) in different entities. However, data from large patient cohorts with electrical heart disease are rare. Therefore, we investigated these patients as well as patients with hypertrophic cardiomyopathy by analyzing registry data from a multi-center ‘real-life’ registry.

Methods

The German Device Registry (DEVICE) is a nationwide, prospective registry with one-year follow-up investigating 5450 patients receiving device implantations in 50 German centers. The present analysis of DEVICE focussed on patients with electrical heart disease or HCM who received an ICD for primary or secondary prevention.

Results

174 patients with HCM and 112 patients with electrical heart disease (long-QT syndrome, Brugada syndrome and arrhythmogenic right ventricular cardiomyopathy) were compared with 5164 other ICD patients. Median follow-up was 17.0 months. Patients in the control group were significantly older. Of note, overall mortality after 1 year was 1.8% in HCM patients, 6.6% in patients with electrical heart disease and 7.3% in the control group. Patients in the control group presented significantly more severe comorbidities. In contrast to HCM patients and the control group where primary prevention was the major indication for ICD implantation, 77.5% of patients with electrical heart disease received an ICD for secondary prevention. The number of surgical revisions was higher in patients with electrical heart disease.

Conclusion

Data from the present registry display a surprisingly high mortality in patients with electrical heart disease equivalent to the control group. A high proportion of patients who received an ICD for secondary prevention may be regarded as a major determinant for these results, while severe comorbidities such as diabetes, hypertension, and renal failure are major determinants for mortality in the control cohort.

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Authors and Affiliations

  1. Clinic for Cardiology II—Electrophysiology, University of Münster, Albert-Schweitzer Campus 1, 48149, Münster, Germany

    Gerrit Frommeyer, Florian Reinke & Lars Eckardt

  2. Department of Cardiology, Kardiologie Am Hubertus-Krankenhaus, Berlin, Germany

    Dietrich Andresen

  3. Department of Cardiology, Klinikum Ludwigshafen, Ludwigshafen, Germany

    Thomas Kleemann

  4. Praxisklinik Herz Und Gefäße Dresden, Dresden, Germany

    Stefan G. Spitzer

  5. Department of Cardiology, Klinikum Straubing, Straubing, Germany

    Joachim Jehle

  6. Department of Cardiology, Klinikum Coburg, Coburg, Germany

    Johannes Brachmann

  7. Department of Cardiology, Klinikum Bielefeld, Bielefeld, Germany

    Christoph Stellbrink

  8. Stiftung Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany

    Matthias Hochadel & Jochen Senges

Authors
  1. Gerrit Frommeyer
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  2. Florian Reinke
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  3. Dietrich Andresen
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  4. Thomas Kleemann
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  5. Stefan G. Spitzer
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  6. Joachim Jehle
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  7. Johannes Brachmann
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  8. Christoph Stellbrink
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  9. Matthias Hochadel
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  10. Jochen Senges
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  11. Lars Eckardt
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Correspondence to Gerrit Frommeyer.

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Frommeyer, G., Reinke, F., Andresen, D. et al. Implantable cardioverter defibrillators in patients with electrical heart disease and hypertrophic cardiomyopathy: data from the German device registry. Clin Res Cardiol 109, 508–512 (2020). https://doi.org/10.1007/s00392-019-01532-9

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  • DOI: https://doi.org/10.1007/s00392-019-01532-9

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