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Can we rely on Danish? Real-world data on patients with nonischemic cardiomyopathy from the German Device Registry

  • Gerrit Frommeyer
  • Dietrich Andresen
  • Hüseyin Ince
  • Sebastian Maier
  • Christoph Stellbrink
  • Thomas Kleemann
  • Karlheinz Seidl
  • Ellen Hoffmann
  • Bernhard Zrenner
  • Matthias Hochadel
  • Jochen Senges
  • Lars Eckardt
Original Article
  • 15 Downloads

Abstract

According to current guidelines prophylactic implantable cardioverter-defibrillator (ICD) therapy is recommended in patients with significantly impaired left ventricular systolic function. However, the recently published DANISH trial did not find a significantly lower long-term rate of death from any cause compared with usual clinical care in patients with non-ischemic cardiomyopathy. We investigated whether registry data from a multi-center ‘real-life’ registry on patients with non-ischemic cardiomyopathy are similar to this trial. The German Device Registry (DEVICE) is a nationwide, prospective registry with one-year follow-up investigating 5451 patients receiving device implantations in 50 German centers. The present analysis of DEVICE focused on patients with non-ischemic cardiomyopathy and a left ventricular ejection fraction ≤35% who received a prophylactic ICD. Out of 779 patients with symptomatic heart failure and nonischemic cardiomyopathy, 33.1% received a single chamber ICD (VVI), while 11.0% were implanted with a dual-chamber ICD (DDD), and 55.8% received a defibrillator system for cardiac resynchronization therapy. Median follow-up was 16.1 months. 90.7% were alive at follow-up, 9.3% had died during this period. Overall mortality after one year was 5.4%. Overall mortality one year after implantation was significantly increased in patients 68 years and older(7.9%) as compared to younger patients (59–68 years: 2.5%; < 59 years: 3.8%; p < 0.015). Data from the present registry support the recently published results of the DANISH trial. In particular the influence of an increased age as proven in the DANISH trial might also play a role in the present collective. This limits the potential beneficial effect of ICD therapy in particular in the elderly population.

Keywords

Non-ischemic cardiomyopathy ICD implantation Sudden cardiac death Age-dependent effects 

Notes

Compliance with ethical standards

Conflict of interest

Karlheinz Seidl reported lecture honoraria from Medtronic and St. Jude Medical. All other authors declared no conflict of interest related to this study.

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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Gerrit Frommeyer
    • 1
  • Dietrich Andresen
    • 2
  • Hüseyin Ince
    • 3
    • 4
  • Sebastian Maier
    • 5
  • Christoph Stellbrink
    • 6
  • Thomas Kleemann
    • 7
  • Karlheinz Seidl
    • 8
  • Ellen Hoffmann
    • 9
  • Bernhard Zrenner
    • 10
  • Matthias Hochadel
    • 11
  • Jochen Senges
    • 11
  • Lars Eckardt
    • 1
  1. 1.Division of Electrophysiology, Department of Cardiovascular MedicineUniversity of MünsterMünsterGermany
  2. 2.Department of CardiologyKardiologie Am Hubertus-KrankenhausBerlinGermany
  3. 3.Department of CardiologyVivantes Klinikum Am Urban Und Im FriedrichshainBerlinGermany
  4. 4.Universitätsmedizin RostockRostockGermany
  5. 5.Department of CardiologyKlinikum StraubingStraubingGermany
  6. 6.Department of CardiologyKlinikum BielefeldBielefeldGermany
  7. 7.Department of CardiologyKlinikum LudwigshafenLudwigshafenGermany
  8. 8.Department of CardiologyKlinikum IngolstadtIngolstadtGermany
  9. 9.Department of CardiologyHeart Center Munich-BogenhausenMunichGermany
  10. 10.Department of CardiologyKrankenhaus Landshut-AchdorfLandshutGermany
  11. 11.Stiftung Institut für Herzinfarktforschung (IHF)LudwigshafenGermany

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