VENTRICULAR ARRHYTMIAS IN PATIENTS WITH IMPLANTED ICD: A POST HOC ANALYSIS OF PRAGUE OHCA TRIAL

Background

Implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT-D) devices are routinely implanted as a secondary prevention of sudden cardiac death, however, the number and characteristics of ventricular arrhythmias after the secondary prevention implantation has been rarely analysed. No data are available in patients after refractory out-of-hospital cardiac arrest (OHCA) treated with extracorporeal cardiopulmonary resuscitation (ECPR) methods.

Purpose

The aim is to specify cumulative incidence of malignant arrhythmias during follow-up in survivors of refractory OHCA partially treated with ECPR with later ICD / CRT-D implantation.

Patients and Methods

We performed a post-hoc analysis of the ICD interrogation records of patients after refractory OHCA who were originally randomised to either standard care of invasive care (intra-arrest transport, ECPR and invasive assessment) within Prague OHCA trial, and were referred to ICD or CRT / CRT-D implantation.

Results:

A total of 31 patients were included in post-hoc analysis. Of these, 17 were randomized to invasive group and 14 to standard resuscitation care. The mean age of the patients in the invasive and standard groups was 55 and 53 years, respectively. 93% and 81% were males with follow-up for 43 and 49 months. 7 and 11 patients had non-sustainable ventricular tachycardia in invasive and standard group (p=0.09). ICD or CRT-D shocks were observed in 3 patients in the invasive group and in 6 patients in the standard care group (p=0.12).

Conclusion:

Among patients who were randomized to Prague OHCA trial and later underwent ICD or CRT-D implantation, ventricular arrhythmias seemed to be more frequently detect