Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2016;69:272-8 - Vol. 69 Num.03 DOI: 10.1016/j.rec.2015.05.016

Primary Prevention of Sudden Death in Patients With Valvular Cardiomyopathy

Moisés Rodríguez-Mañero a,, María Teresa Barrio-López b, Emad Abu Assi a, Víctor Expósito-García c, Vicente Bertomeu-González d, Juan Miguel Sánchez-Gómez e, Luis González-Torres f, Ignacio García-Bolao g, Larraitz Gaztañaga h, Pilar Cabanas-Grandío i, José Antonio Iglesias-Bravo j, Álvaro Arce-León k, Ana Andrés la Huerta l, Juan Fernández-Armenta m, Rafael Peinado n, Miguel Angel Arias o, Ernesto Díaz-Infante f

a Unidad de Arritmias, Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
b Unidad de Arritmias, Servicio de Cardiología, Hospital Virgen de las Nieves, Granada, Spain
c Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
d Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario de San Juan, Sant Joan d’Alacant, Alicante, Spain
e Unidad de Arritmias, Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain
f Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen Macarena, Seville, Spain
g Unidad de Arritmias, Servicio de Cardiología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
h Unidad de Arritmias, Servicio de Cardiología, Hospital de Basurto, Bilbao, Vizcaya, Spain
i Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario de Vigo, Vigo, Pontevedra, Spain
j Unidad de Arritmias, Servicio de Cardiología, Hospital Fundación Jiménez Díaz, Madrid, Spain
k Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Seville, Spain
l Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
m Unidad de Arritmias, Servicio de Cardiología, Hospital Puerta del Mar, Cádiz, Spain
n Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
o Unidad de Arritmias, Servicio de Cardiología, Hospital Virgen de la Salud, Toledo, Spain

Keywords

Valvular cardiomyopathy. Implantable cardioverter-defibrillator. Primary prevention of sudden cardiac death. Appropriate interventions. Inappropriate interventions.

Abstract

Introduction and objectives

Few data exist on the outcomes of valvular cardiomyopathy patients referred for defibrillator implantation for primary prevention. The aim of the present study was to describe the outcomes of this cardiomyopathy subgroup.

Methods

This multicenter retrospective study included consecutive patients referred for defibrillator implantation to 15 Spanish centers in 2010 and 2011, and to 3 centers after 1 January 2008.

Results

Of 1174 patients, 73 (6.2%) had valvular cardiomyopathy. These patients had worse functional class, wider QRS, and a history of atrial fibrillation vs patients with ischemic (n = 659; 56.1%) or dilated (n = 442; 37.6%) cardiomyopathy. During a follow-up of 38.1 ± 21.3 months, 197 patients (16.7%) died, without significant differences among the groups (19.2% in the valvular cardiomyopathy group, 15.8% in the ischemic cardiomyopathy group, and 17.9% in the dilated cardiomyopathy group; P = .2); 136 died of cardiovascular causes (11.6%), without significant differences among the groups (12.3%, 10.5%, and 13.1%, respectively; P = .1). Although there were no differences in the proportion of appropriate defibrillator interventions (13.7%, 17.9%, and 18.8%; P = .4), there was a difference in inappropriate interventions (8.2%, 7.1%, and 12.0%, respectively; P = .03).

Conclusions

All-cause and cardiovascular mortality in patients with valvular cardiomyopathy were similar to those in other patients referred for defibrillator implantation. They also had similar rates of appropriate interventions. These data suggest that defibrillator implantation in this patient group confers a similar benefit to that obtained by patients with ischemic or dilated cardiomyopathy.

1885-5857/© 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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