Abstract
Study Objective: To estimate the proportion of patients eligible for implantable cardioverter defibrillator (ICD) therapy for the primary prevention of sudden cardiac death after a myocardial infarction (MI), according to the current guidelines.
Methods: Eligibility was assessed retrospectively at 6 weeks in 513 post-MI survivors (age 66 +/- 13 years, left ventricular ejection fraction 48.2 +/- 17%) on the basis of an electrocardiogram and an echocardiogram.
Results: LVEF was <= 40% in 37% and <= 35% in 30%, and QRS duration was <120 ms in 89% and >= 120 ins in 11% of patients. The proportion of post-MI patients meeting the criteria set by guidelines were 37% for 2006 American College of Cardiology/American Heart Associotion/European Society of Cardiology (ACC/AHA/ESC) 26.5% for 2008 ACC/AHA/Canadian Heart Rhythm Society 16.3% for 2005 US Centers for Medicare and Medicaid Services (CMS), and 5.8% for the 2006 United Kingdom (UK) National Institute of Clinical Excellence (NICE). According to 2005 CMS and 2006 UK-NICE guidelines, Holter monitoring was required in 7% and 18%, respectively. For the United States (700,000 MI in 2006), the 2006 ACC/AHA/ESC guidelines equate to 216,783 ICD implantationslyear. For UK (60,499 MI in 2006), the 2006 NICE guidelines equate to 2,941 ICD implantations, 10,488 Holter studies, and 1,065 VT induction tests/year.
Conclusions: Current ICD therapy guidelines for primary prevention of SCD post-MI demand a substantial increase in service provision worldwide. (PACE 2009; 32:S131-S134)
| Original language | English |
|---|---|
| Pages (from-to) | S131-134 |
| Number of pages | 4 |
| Journal | PACE |
| Volume | 32 |
| Issue number | Suppl. 1 |
| DOIs | |
| Publication status | Published - Mar 2009 |
Keywords
- primary prevention
- sudden cardiac death
- implantable cardioverter defibrillator
- myocardial infarction
- ventricular tachyarrhythmia
- MADIT-II
Cite this
Implantable Cardioverter Defibrillator Therapy for Primary Prevention of Sudden Cardiac Death after Myocardial Infarction : Implications of International Guidelines. / Foley, Paul W. X.; Addison, Carol; Whinney, Stephanie B.; Patel, Kiran; Cunningham, David; Frenneaux, Michael; Leyva, Francisco.
In: PACE, Vol. 32, No. Suppl. 1, 03.2009, p. S131-134.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Implantable Cardioverter Defibrillator Therapy for Primary Prevention of Sudden Cardiac Death after Myocardial Infarction
T2 - Implications of International Guidelines
AU - Foley, Paul W. X.
AU - Addison, Carol
AU - Whinney, Stephanie B.
AU - Patel, Kiran
AU - Cunningham, David
AU - Frenneaux, Michael
AU - Leyva, Francisco
PY - 2009/3
Y1 - 2009/3
N2 - Study Objective: To estimate the proportion of patients eligible for implantable cardioverter defibrillator (ICD) therapy for the primary prevention of sudden cardiac death after a myocardial infarction (MI), according to the current guidelines.Methods: Eligibility was assessed retrospectively at 6 weeks in 513 post-MI survivors (age 66 +/- 13 years, left ventricular ejection fraction 48.2 +/- 17%) on the basis of an electrocardiogram and an echocardiogram.Results: LVEF was <= 40% in 37% and <= 35% in 30%, and QRS duration was <120 ms in 89% and >= 120 ins in 11% of patients. The proportion of post-MI patients meeting the criteria set by guidelines were 37% for 2006 American College of Cardiology/American Heart Associotion/European Society of Cardiology (ACC/AHA/ESC) 26.5% for 2008 ACC/AHA/Canadian Heart Rhythm Society 16.3% for 2005 US Centers for Medicare and Medicaid Services (CMS), and 5.8% for the 2006 United Kingdom (UK) National Institute of Clinical Excellence (NICE). According to 2005 CMS and 2006 UK-NICE guidelines, Holter monitoring was required in 7% and 18%, respectively. For the United States (700,000 MI in 2006), the 2006 ACC/AHA/ESC guidelines equate to 216,783 ICD implantationslyear. For UK (60,499 MI in 2006), the 2006 NICE guidelines equate to 2,941 ICD implantations, 10,488 Holter studies, and 1,065 VT induction tests/year.Conclusions: Current ICD therapy guidelines for primary prevention of SCD post-MI demand a substantial increase in service provision worldwide. (PACE 2009; 32:S131-S134)
AB - Study Objective: To estimate the proportion of patients eligible for implantable cardioverter defibrillator (ICD) therapy for the primary prevention of sudden cardiac death after a myocardial infarction (MI), according to the current guidelines.Methods: Eligibility was assessed retrospectively at 6 weeks in 513 post-MI survivors (age 66 +/- 13 years, left ventricular ejection fraction 48.2 +/- 17%) on the basis of an electrocardiogram and an echocardiogram.Results: LVEF was <= 40% in 37% and <= 35% in 30%, and QRS duration was <120 ms in 89% and >= 120 ins in 11% of patients. The proportion of post-MI patients meeting the criteria set by guidelines were 37% for 2006 American College of Cardiology/American Heart Associotion/European Society of Cardiology (ACC/AHA/ESC) 26.5% for 2008 ACC/AHA/Canadian Heart Rhythm Society 16.3% for 2005 US Centers for Medicare and Medicaid Services (CMS), and 5.8% for the 2006 United Kingdom (UK) National Institute of Clinical Excellence (NICE). According to 2005 CMS and 2006 UK-NICE guidelines, Holter monitoring was required in 7% and 18%, respectively. For the United States (700,000 MI in 2006), the 2006 ACC/AHA/ESC guidelines equate to 216,783 ICD implantationslyear. For UK (60,499 MI in 2006), the 2006 NICE guidelines equate to 2,941 ICD implantations, 10,488 Holter studies, and 1,065 VT induction tests/year.Conclusions: Current ICD therapy guidelines for primary prevention of SCD post-MI demand a substantial increase in service provision worldwide. (PACE 2009; 32:S131-S134)
KW - primary prevention
KW - sudden cardiac death
KW - implantable cardioverter defibrillator
KW - myocardial infarction
KW - ventricular tachyarrhythmia
KW - MADIT-II
U2 - 10.1111/j.1540-8159.2008.02268.x
DO - 10.1111/j.1540-8159.2008.02268.x
M3 - Article
VL - 32
SP - S131-134
JO - PACE
JF - PACE
SN - 0147-8389
IS - Suppl. 1
ER -