PURPOSE:To investigate the prevalence of appropriate implantable cardioverter-defibrillator (ICD) shocks in 1,038 consecutive patients with ICDs in an academic cardiology practice.
METHODS:In an academic cardiology practice, 1,038 consecutive patients received an ICD according to American College of Cardiology/American Heart Association guidelines. The 1,038 patients included 829 men and 209 women, mean age 70±14 years. At follow-up every 3 months, the ICD was interrogated to see if any shocks occurred. The shocks were further evaluated by an electrophysiologist viewing the intracardiac electrocardiograms to see if they were appropriate. Follow-up was 977 ± 994 days.
RESULTS:Appropriate ICD shocks occurred in 268 of 829 men (32%), in 61 of 209 women (29%), and in 329 of 1,038 patients (32%). Time to first appropriate shock was 634 ± 739 days. Appropriate ICD shocks occurred in 101 of 380 patients (27%) treated with beta –adrenergic blockers alone, 1 in 31 of 95 patients (33%) treated with amiodarone alone, 2 in 39 of 149 patients (26%) treated with beta blockers plus amiodarone, 3 in 11 of 28 patients (39%) treated with sotalol alone, 4 and in 147 of 386 patients (38%) treated with no beta blockers, amiodarone, or sotalol5 (p<0.001 comparing 1 with 5 and p<0.01 comparing 3 with 5).
CONCLUSION:Patients with ICDs should be treated with beta blockers to reduce the frequency of appropriate ICD shocks.
CLINICAL IMPLICATIONS:Patients with ICDs should be treated with beta blockers to reduce the frequency of appropriate ICD shocks.
DISCLOSURE:Adam Kruger, No Financial Disclosure Information; No Product/Research Disclosure Information