Cor Vasa 2010, 52(1-2):36-38 | DOI: 10.33678/cor.2010.007
Indications for ICD implantation in the primary prevention of sudden cardiac death after a STEMI. The impact of a change in the Czech Society of Cardiology guidelines on the number of patients scheduled for the procedure
- Kardiocentrum, Krajská nemocnice Liberec, Česká republika
Aim: The aim of this original contribution was to compare the number of patients scheduled for primary preventive ICD implantation according to the old (2005) and new (2009) Guidelines of the Czech Society of Cardiology in patients after ST-segment elevation myocardial infarction (STEMI).
Methods and results: We examined 205 consecutive patients 12-29 months after STEMI. We took their history, and ECHO and ECG were performed. No electrophysiology study was performed. Based on these examinations, we assessed the indication for ICD implantation in the primary prevention of sudden cardiac death according to the old and new guidelines. A total of 310 patients were hospitalized because of STEMI in our cardiac centre from December 2006 through December 2007. Of these, 5.2% died before discharge and 2.7% after discharge, before their scheduled examination. The other patients were invited to follow-up visits, but 81 failed to come. Using the old and new guideline criteria, ICD implantation was indicated in four and 25 patients, respectively. When taking into account all STEMI patients, 1.3-1.8% and 8.1-11.3%, respectively, were scheduled for primary preventive ICD implantation.
Conclusion: Following the implementation of the new (2009) Guidelines of the Czech Society of Cardiology, we found a six-fold increase in the primary preventive indication for ICD implantation in the population of patients with coronary artery disease after STEMI.
Keywords: ST-segment elevation myocardial infarction; Implantable cardioverter-defibrillator; Sudden cardiac death
Published: January 1, 2010 Show citation
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