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Decrease in cardiac arrests linked to ICDs
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Implantable cardioverter defibrillators accounted for approximately 33% of the decrease in cardiac arrests caused by ventricular fibrillation during the past decade in the province of North Holland in the Netherlands, according to data published in Circulation.
Study results also showed that 1,972 patients with ICDs received 977 shocks from 2005 to 2008, 339 of which were triggered by lethal arrhythmias. These shocks, researchers concluded, prevented an estimated 81 cases of ventricular fibrillation-related cardiac arrests.
“Over the last decades, a gradual decrease in ventricular fibrillation as initial recorded rhythm during resuscitation for out-of-hospital cardiac arrest has been noted,” Rudolph W. Koster, MD, PhD, senior study researcher and associate professor of cardiology at the Academic Medical Center in Amsterdam, and colleagues wrote. “We sought to establish the contribution of ICD therapy to this decline.”
The researchers used the ARREST registry — a prospective database of all out-of-hospital cardiac arrest resuscitation efforts in North Holland — to compare data from 1995 to 1997 with data from 2005 to 2008.
The annual incidence of cardiac arrest caused by ventricular fibrillation declined from 21.1 per 100,000 person-years from 1995 to 1997 to 17.4 per 100,000 person-years from 2005 to 2008 (P<.001). In contrast, incidence of cardiac arrest related to other arrhythmias increased significantly from 12.2 to 19.4 per 100,000 person-years throughout the 10-year study period (P<.001).
Data also indicated that the proportion of cardiac arrest patients presenting with ventricular fibrillation decreased from 63% to 47%.
Although ICDs contributed to the decreased incidence of cardiac arrests caused by ventricular fibrillation, what caused the other two-thirds of the decline remains unclear, the researchers noted.
“The possible mechanisms are only guesses without much solid evidence,” Koster said in a press release.
Disclosure: The researchers report no relevant financial disclosures.
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