Comparison of the usefulness of the implantable cardioverter-defibrillator and subendocardial resection in patients with sustained ventricular arrhythmias and poor regional wall motion associated with coronary artery disease. The American journal of cardiology. [Am J Cardiol] Journal article | | Title | Comparison of the usefulness of the implantable cardioverter-defibrillator and subendocardial resection in patients with sustained ventricular arrhythmias and poor regional wall motion associated with coronary artery disease. | | Author(s) | Nath S, Haines DE, DeLacey WA, Berry VA, Barber MJ, Kron IL, DiMarco JP | | Institution | Department of Medicine, University of Virginia Health Sciences Center, Charlottesville 22908. | | Source | Am J Cardiol 1993 Sep 15; 72(9):652-7. | | MeSH | Cause of Death
Comparative Study
Coronary Disease
Death, Sudden, Cardiac
Defibrillators, Implantable
Electrocardiography
Endocardium
Female
Follow-Up Studies
Heart Conduction System
Humans
Male
Middle Aged
Myocardial Contraction
Research Support, Non-U.S. Gov't
Retrospective Studies
Risk Factors
Stroke Volume
Survival Rate
Tachycardia, Ventricular
Treatment Outcome
Ventricular Function, Left
| | Abstract | The implantable cardioverter-defibrillator (ICD) and subendocardial resection are effective forms of therapy for sustained ventricular arrhythmias associated with coronary artery disease in selected patients. The relative efficacy of these 2 treatments in equivalently matched patients is not known. A regional wall motion score has been shown to be a powerful predictor of long-term outcome after both ICD implantation and subendocardial resection. This study retrospectively analyzed the long-term outcome of patients with coronary artery disease and ventricular arrhythmias treated during the same period with an ICD (n = 53) or by subendocardial resection (n = 65). Treatment outcomes were compared in subgroups determined by preoperative regional wall motion scores of either < or = 16 or > 16%. The 3-year cardiac mortality of the 2 therapies was not significantly different among patients with a wall motion score of > 16% (0% ICD vs 11% endocardial resection) or of < or = 16% (41% ICD vs 35% endocardial resection). Similarly, the 3-year sudden cardiac death mortality was similar among patients with a score of > 16% (0% for both ICD and endocardial resection) or of < or = 16% (9% ICD vs 14% endocardial resection, p = NS). At 24 months after hospital discharge, the percentage of patients who were in New York Heart Association functional class I or II was similar among patients with a wall motion score of > 16% (75% ICD vs 86% endocardial resection, p = NS) or with a wall motion score of < or = 16% (26% ICD vs 45% endocardial resection, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS) | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 8249839 |
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