Abstract 664: Long-Term Cinical Outcome of Patients with Idiopathic Ventricular Fibrillation with Defibrillators
Objective and Background: Ventricular Fibrillation (VF) in the absence of structural or electrical heart disease is rare but well documented. We report long-term arrhythmia recurrence and survival data in a cohort of 34 patients with Idiopathic VF after ICD implantation.
Methods and results: 34 consecutive patients with successful rescuscitation from idiopathic VF, no definable structural heart disease and no obvious inherited arrhythmia conditions were implanted with ICDs for secondary prevention. They were followed for an average of 113± 64.3 months. Patients were excluded if impairment from their VF arrest limited function or survival. During the follow-up interval, 14 patients died, and 17 patients had a total of 20 appropriate ICD therapies. The 1-, 5- and 10- year survival in this cohort was compared to age-matched patients with ICDs and structural heart disease and to an age-matched normal population. The 1-, 5-, 10-year survival of 97%, 73%, and 62% respectively, in the studied cohort was significantly better than that of patients with structural heart disease (p<0.002). However, the survival in the study cohort was much worse than an age-matched normal cohort where the 1-, 5-, and 10-year survival were 98%, 94% and 87% respectively. Older age at presentation was an independent predictor of poor outcome (compared to age <55 years, age 55– 69, RR 1.71, age >69, RR 2.38, p<0.001). No other variables predicted mortality in this group.
Conclusions: The prognosis in IVF albeit “good” when compared to patients with structurally abnormal hearts, is significantly worse than normal controls. ICD implantation may not be a “cure” in this subset of patients.