Implantable cardioverter-defibrillators in cardiac transplant recipients: A systematic review from the Electrophysiology Collaborative Consortium for Meta-analysis-ELECTRAM investigators.

Document Type

Article

Publication Date

12-1-2020

Publication Title

Pacing and Clinical Electrophysiology : PACE

Abstract

INTRODUCTION: Implantable cardioverter-defibrillator (ICD) in patients with heart failure with reduced ejection fraction reduces mortality secondary to malignant arrhythmias. Whether cardiac transplant patients considered high risk for sudden death (SD) derive similar benefits remains controversial.

METHODS: Systematic search, without language restriction, using PubMed, EMBASE, SCOPUS, Google Scholar, and ClinicalTrials.gov was performed from inception to June 4, 2020, for studies that had reported outcomes in patients who had ICD implanted after cardiac transplant. The outcomes studied were as follows: (a) SD and (b) appropriate and inappropriate ICD therapies.

RESULTS: Seven studies (from 1983 through 2018) with a total of 338 cardiac transplant patients who received ICD met study inclusion criteria. The mean age was 48.37 ± 14.85 years, and 70.4% were men. The pooled incidence of SD was 16.3% (95% CI 6.2-29.0%; I

CONCLUSION: Despite, low incidence of arrhythmic mortality, there remains an increased burden of ventricular arrhythmias, as evident by a 12% appropriate ICD shock rates, suggesting ICD might be a practical decision in selected cardiac transplant patients deemed high risk of SD (i.e., patients with advanced CAV and left ventricular systolic dysfunction).

Volume

43

Issue

12

First Page

1529

Last Page

1537

DOI

10.1111/pace.14098

ISSN

1540-8159

PubMed ID

33180346

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