Arrhythmias & electrophysiologyCohort study
Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe
- Retrospective cohort study
- multicentre registries, 11 countries
Authors' conclusion
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.
Study context
- Population
- Arrhythmogenic right ventricular cardiomyopathy (ARVC) patients without prior ventricular arrhythmia (VA), clinical registries in Europe and North America, stratified by predicted VA risk (low <10%/5 years, intermediate 10%-25%/5 years, high >25%/5 years)
- Participants
- 1,098 patients
- Exposure
- North America vs Europe
- Outcome
- Primary prevention ICD implantation and survival free from sustained VA (including appropriate ICD therapy)
- Follow-up
- Median 5.1 years
Main finding
As reported in the abstract
North America vs EuropeHazard ratio (95% CI)
ICD implantation, adjusted for baseline risk factors
3.1(2.5–3.8)
incident sustained VA, adjusted
1.4(1.1–1.8)
- Primary prevention ICD (overall)
- 554 (50.5%)
- First VA event (overall)
- 286 (26.0%)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Incident sustained VA in patients without ICDs (subgroup) | 2.1 (1.3–3.4) | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe. Eur Heart J. Published 9 January 2024. doi:10.1093/eurheartj/ehad799
Summarised from the published abstract; every number is checked against it