Outcome of patients with nonischemic dilated cardiomyopathy and unexplained syncope treated with an implantable defibrillator

Bradley P. Knight*, Rajiva Goyal, Frank Pelosi, Matthew Flemming, Laura Horwood, Fred Morady, S. Adam Strickberger

*Corresponding author for this work

Research output: Contribution to journalArticle

192 Scopus citations

Abstract

OBJECTIVES: The purpose of this study was to determine the outcome of patients with nonischemic dilated cardiomyopathy, unexplained syncope and a negative electrophysiology test who are treated with an implantable defibrillator. BACKGROUND: Patients with nonischemic cardiomyopathy and unexplained syncope may be at high risk for sudden cardiac death, and they are sometimes treated with an implantable defibrillator. METHODS: This study prospectively determined the outcome of 14 consecutive patients who had a nonischemic cardiomyopathy, unexplained syncope and a negative electrophysiology test and who underwent defibrillator implantation (Syncope Group). Nineteen consecutive patients with a nonischemic cardiomyopathy and a cardiac arrest who were treated with a defibrillator (Arrest Group) served as a control group. RESULTS: Seven of 14 patients (50%) in the Syncope Group received appropriate shocks for ventricular arrhythmias during a mean follow- up of 24 ± 13 months, compared with 8 of 19 patients (42%) in the Arrest Group during a mean follow-up of 45 ± 40 months (p = 0.1). The mean duration from device implantation until the first appropriate shock was 32 ± 7 months (95% confidence interval [CI], 18 to 45 months) in the Syncope Group compared to 72 ± 12 months (95% CI, 48 to 96 months) in the Arrest Group (p = 0.1). Among patients who received appropriate shocks, the mean time from defibrillator implantation to the first appropriate shock was 10 ± 14 months in the Syncope Group, compared with 48 ± 47 months in the Arrest Group (p = 0.06). Recurrent syncope was always associated with ventricular tachyarrhythmias. CONCLUSIONS: The high incidence of appropriate defibrillator shocks and the association of recurrent syncope with ventricular arrhythmias support the treatment of patients with nonischemic cardiomyopathy, unexplained syncope and a negative electrophysiology test with an implantable defibrillator.

Original languageEnglish (US)
Pages (from-to)1964-1970
Number of pages7
JournalJournal of the American College of Cardiology
Volume33
Issue number7
DOIs
StatePublished - Jun 1 1999

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Outcome of patients with nonischemic dilated cardiomyopathy and unexplained syncope treated with an implantable defibrillator'. Together they form a unique fingerprint.

  • Cite this