Survival of patients with Implantable Cardioverter Defibrillator (ICD) at Ullevål University Hospital, 1984-2004.Johanne Haugen, Malin Fredholm Langlo, Finn Hegbom.
Background. In the western part of the world, cardiac arrest is a frequent cause of death. Every year 5000-8000 persons in Norway are affected. In this study we wanted to look at the survival of patients with implanted cardioverter defibrillator (ICD) at Ullevål University Hospital, in the period of 1984-2004. The primary aim of ICD-implantation is protection against sudden cardiac death caused by ventricular tachyarrhytmia.
Material and method. We have observed a material of 264 ICD-patients and registered some important predictors of mortality. Patients were followed at least 6 months after the implantation.
Results. The indications for ICD therapy at Ullevål University Hospital are related to clinical presentation, such as survival of sudden cardiac arrest (39%), ventricular tachycardia (27%) and syncope (27%). The overall survival after 5 years was 78%. Patients with left ventricular ejection fraction (EF) < 35% have a mortality-risk of 108% compared to the group of patients with EF > 35% (p=0,018). Survivors of cardiac arrest have an increased mortality-risk of 85% (p=0,034). An age-increase of 10 years also increased the mortality-risk with 81% (p=0,001).
Interpretation. The most important predictors of survival in ICD-patients at Ullevål University Hostpital are EF, age and earlier cardiac arrest. We found a significantly lower 5-years survival of patients with EF < 35% and patients with clinical presentation of cardiac arrest. An age-increase of 10 years is also a significant riskfactor.