Single chamber implantable cardioverter defibrillator compared to dual chamber implantable cardioverter defibrillator: less is more! Data from the German Device Registry

Bogossian, Harilaos; Frommeyer, Gerrit; Hochadel, Matthias; Ince, Huseyin; Spitzer, Stefan G.; Eckardt, Lars; Maier, Sebastian K. G.; Kleemann, Thomas; Brachmann, Johannes; Stellbrink, Christoph; Gonska, Bernd-Dieter; Kääb, Stefan; Senges, Jochen und Lemke, Bernd (2019): Single chamber implantable cardioverter defibrillator compared to dual chamber implantable cardioverter defibrillator: less is more! Data from the German Device Registry. In: Clinical Research in Cardiology, Bd. 109, Nr. 7: S. 911-917

Abstract

Background In patients with high risk for sudden cardiac death the implantation of a defibrillator is an established treatment. However the benefits and risks for patients in accordance to the number of the leads are not clear. Even in the current guidelines a recommendation to this question is missing. We analyzed advantage and disadvantages of single-chamber implantable cardioverter defibrillators (VVI-ICD) versus dual-chamber implantable cardioverter defibrillators (DDD-ICD) in the prospective German Device Registry. Methods The data of 2240 patients who underwent ICD implantation in 45 German Centers between January 2007 and March 2011 were included in a prospective device registry (VVI:n = 1629, male = 1358, EF = 34% +/- 13%;DDD:n = 611, male = 491, EF = 35% +/- 14%). Results The in-hospital complications were significantly higher in the DDD-ICD group with higher revision/device complication rates (3.0% vs. 1.2%;p = 0.003) but also higher mortality rate (1.0% vs. 0.1%;p < 0.001). Regarding the adjusted data at 1-year follow-up DDD-ICD caused more device revisions, but no difference in rehospitalization and mortality. Conclusion It is still unclear whether DDD-ICD may be beneficial for patients with preserved sinus and atrioventricular nodal function. Our data show that the decision of the operator to choose a DDD-ICD in these patients must be taken very carefully. By choosing a DDD-ICD the patient is exposed to a significantly higher periprocedural complication rate and higher in-hospital mortality. In absence of relevant bradycardias implantation of a DDD-ICD is not justified. Graphic abstract

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1861-0684
• Sprache: Englisch