Mode of death and outcomes of implantable cardioverter defibrillators in transthyretin amyloid cardiomyopathy

Zack Dale, Lana Al-Rashdan, Miriam Elman, Pranav Chandrashekar, Stephen Heitner, Babak Nazer, Ahmad Masri

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: Transthyretin cardiac amyloidosis (ATTR-CM) may associate with sudden cardiac death. We report on the mode of death and outcomes with implantable cardioverter defibrillators (ICDs) in a cohort with ATTR-CM. Methods: A single center observational cohort study of patients with ATTR-CM diagnosed between 2005 and 2019. ICD implant was at discretion of treating cardiologists. Medians are expressed with 25th,75th percentiles. Results: Eighty-four patients with ATTR-CM (age 73.5 ± 9.7 years, 94% male, median follow-up 21.1 months (11.4–38.1). Nineteen patients (23%) underwent ICD implantation – 18 for primary and 1 for secondary prevention. In the primary prevention ICD group, 1 patient had 2 inappropriate shocks, 1 patient had appropriate ATP on 3 occasions. One patient (mixed ischemic cardiomyopathy and ATTR-CM) with secondary prevention ICD had 15 appropriate shocks in 3 episodes of VT storm. In patients without ICD, ambulatory monitoring review (14,764 h) did not reveal sustained ventricular arrhythmia. Excluding the one patient with secondary prevention ICD, 5 (28%) in the primary prevention ICD group and 22 (34%) in the non-ICD group died, p = 0.14. Mode of death did not vary between both groups. Conclusions: Patients with ATTR-CM and primary prevention ICD infrequently receive appropriate device therapy without differing in mode of death, which was mainly related to progressive heart failure, compared to those without ICD.

Original languageEnglish (US)
Pages (from-to)99-102
Number of pages4
JournalInternational Journal of Cardiology
Volume349
DOIs
StatePublished - Feb 15 2022

Keywords

  • Cardiac amyloidosis
  • Implantable cardioverter-defibrillator
  • Transthyretin amyloidosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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