Arrhythmias & electrophysiologyCohort study
Incidence and Predictors of Appropriate Implantable Cardioverter-Defibrillator Therapy in Light Chain Cardiac Amyloidosis
- retrospective, single referral center study
Authors' conclusion
AL CA patients implanted with prophylactic ICDs experience high rates of appropriate therapies. Assessment of LV involvement with LV global longitudinal strain might improve risk stratification for ventricular arrhythmias. Further studies are needed to assess the impact of ICD on overall survival in this population.
Study context
- Population
- AL CA patients implanted with implantable cardioverter defibrillator (ICDs) between November 2014 and May 2024, all with primary prevention ICDsmean age 63.4 ± 9.2 years, 65.3% male
- Participants
- 150 patients
- Outcome
- First appropriate ICD therapy (shock or antitachycardia pacing)
- Follow-up
- Median 16.8 months (Q1-Q3: 5.4-56.5 months)
Main finding
As reported in the abstract
Patients receiving at least 1 appropriate ICD therapy
27 (18.0%)
1-year cumulative incidence
11.6%; 95% CI: 7.4%-18.2%
5-year cumulative incidence
19.5%; 95% CI: 13.4%-28.4%
Observational data: associations, not effects.
Further findings
Appropriate ICD therapy, impaired left ventricular (LV) global longitudinal strain (multivariate analysis)
- Adjusted subdistribution HR for impaired LV global longitudinal strain (optimal cutoff −9.5%)
- 5.33; 95% CI: 1.99-14.26; P = 0.0009
- independently associated with a higher risk of appropriate ICD therapy
Original publication
Summarised from the published abstract; every number is checked against it