Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe
(2024) In European Heart Journal 45(7). p.538-548- Abstract
- Background and Aims: Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death (SCD) in arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to identify cross-continental differences in utilization of primary prevention ICDs and survival free from sustained ventricular arrhythmia (VA) in ARVC. Methods: This was a retrospective analysis of ARVC patients without prior VA enrolled in clinical registries from 11 countries throughout Europe and North America. Patients were classified according to whether they received treatment in North America or Europe and were further stratified by baseline predicted VA risk into low- (25%/5 years) groups. Differences in ICD implantation and survival... (More)
- Background and Aims: Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death (SCD) in arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to identify cross-continental differences in utilization of primary prevention ICDs and survival free from sustained ventricular arrhythmia (VA) in ARVC. Methods: This was a retrospective analysis of ARVC patients without prior VA enrolled in clinical registries from 11 countries throughout Europe and North America. Patients were classified according to whether they received treatment in North America or Europe and were further stratified by baseline predicted VA risk into low- (25%/5 years) groups. Differences in ICD implantation and survival free from sustained VA events (including appropriate ICD therapy) were assessed. Results: One thousand ninety-eight patients were followed for a median of 5.1 years; 554 (50.5%) received a primary prevention ICD, and 286 (26.0%) experienced a first VA event. After adjusting for baseline risk factors, North Americans were more than three times as likely to receive ICDs {hazard ratio (HR) 3.1 [95% confidence interval (CI) 2.5, 3.8]} but had only mildly increased risk for incident sustained VA [HR 1.4 (95% CI 1.1, 1.8)]. North Americans without ICDs were at higher risk for incident sustained VA [HR 2.1 (95% CI 1.3, 3.4)] than Europeans. Conclusions: North American ARVC patients were substantially more likely than Europeans to receive primary prevention ICDs across all arrhythmic risk strata. A lower rate of ICD implantation in Europe was not associated with a higher rate of VA events in those without ICDs. © 2024 The Author(s). (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/64c97a85-ca65-4f43-a444-0a77bbb81276
- author
- Carrick, R.T. ; Platonov, P.G. LU and Cadrin-Tourigny, J.
- author collaboration
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Arrhythmogenic right ventricular cardiomyopathy, Implantable cardioverter-defibrillator, Primary prevention, Sudden cardiac death, Ventricular arrhythmia, desmoplakin, phospholamban, adult, Article, cardiovascular mortality, cohort analysis, controlled study, electrocardiogram, female, follow up, genetic screening, genotype, heart failure, heart left ventricle ejection fraction, heart right ventricle ejection fraction, heart transplantation, heart ventricle arrhythmia, heart ventricle fibrillation, heart ventricle tachycardia, human, major clinical study, male, middle aged, observational study, phenotype, prevalence, retrospective study, risk factor, whole exome sequencing
- in
- European Heart Journal
- volume
- 45
- issue
- 7
- pages
- 11 pages
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85185460332
- ISSN
- 0195-668X
- DOI
- 10.1093/eurheartj/ehad799
- language
- English
- LU publication?
- yes
- id
- 64c97a85-ca65-4f43-a444-0a77bbb81276
- date added to LUP
- 2025-10-16 13:41:34
- date last changed
- 2025-10-16 13:42:11
@article{64c97a85-ca65-4f43-a444-0a77bbb81276,
abstract = {{Background and Aims: Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death (SCD) in arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to identify cross-continental differences in utilization of primary prevention ICDs and survival free from sustained ventricular arrhythmia (VA) in ARVC. Methods: This was a retrospective analysis of ARVC patients without prior VA enrolled in clinical registries from 11 countries throughout Europe and North America. Patients were classified according to whether they received treatment in North America or Europe and were further stratified by baseline predicted VA risk into low- (25%/5 years) groups. Differences in ICD implantation and survival free from sustained VA events (including appropriate ICD therapy) were assessed. Results: One thousand ninety-eight patients were followed for a median of 5.1 years; 554 (50.5%) received a primary prevention ICD, and 286 (26.0%) experienced a first VA event. After adjusting for baseline risk factors, North Americans were more than three times as likely to receive ICDs {hazard ratio (HR) 3.1 [95% confidence interval (CI) 2.5, 3.8]} but had only mildly increased risk for incident sustained VA [HR 1.4 (95% CI 1.1, 1.8)]. North Americans without ICDs were at higher risk for incident sustained VA [HR 2.1 (95% CI 1.3, 3.4)] than Europeans. Conclusions: North American ARVC patients were substantially more likely than Europeans to receive primary prevention ICDs across all arrhythmic risk strata. A lower rate of ICD implantation in Europe was not associated with a higher rate of VA events in those without ICDs. © 2024 The Author(s).}},
author = {{Carrick, R.T. and Platonov, P.G. and Cadrin-Tourigny, J.}},
issn = {{0195-668X}},
keywords = {{Arrhythmogenic right ventricular cardiomyopathy; Implantable cardioverter-defibrillator; Primary prevention; Sudden cardiac death; Ventricular arrhythmia; desmoplakin; phospholamban; adult; Article; cardiovascular mortality; cohort analysis; controlled study; electrocardiogram; female; follow up; genetic screening; genotype; heart failure; heart left ventricle ejection fraction; heart right ventricle ejection fraction; heart transplantation; heart ventricle arrhythmia; heart ventricle fibrillation; heart ventricle tachycardia; human; major clinical study; male; middle aged; observational study; phenotype; prevalence; retrospective study; risk factor; whole exome sequencing}},
language = {{eng}},
number = {{7}},
pages = {{538--548}},
publisher = {{Oxford University Press}},
series = {{European Heart Journal}},
title = {{Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe}},
url = {{http://dx.doi.org/10.1093/eurheartj/ehad799}},
doi = {{10.1093/eurheartj/ehad799}},
volume = {{45}},
year = {{2024}},
}