Long-Term Follow-Up of Patients with Nonischemic Dilated Cardiomyopathy and Ventricular Tachyarrhythmias Treated with Implantable Cardioverter Defibrillators

We analyzed our 10-year cumulative experience of 40 consecutive patients with idiopathic dilated Cardiomyopathy and associated ventricular tachyarrhythmias, treated with implantable Cardioverter defibrillators. Dilated Cardiomyopathy was defined as left ventricular ejection fraction (EF) ≤50% with no defineable etiology. Patient characteristics included: 24 male, mean age 52 years, mean EF = 33%, New York Heart Association Class I–III, presenting syndrome—cardiac arrest (n = 28), syncope/near syncope (n = 12). At 2.5 years mean follow-up, there were 16 deaths: one operative, three sudden, two incessant ventricular tachycardia/ventricular fibrillation (VT/VF), six heart failure, and four noncardiac. The actuarial mortality at 1 and 4 years was 0% and 14% for sudden death, 11% and 34% for cardiac death. The projected mortality was 52% and 78% for same time intervals (P < 0.01). No useful baseline variable predicted who would or would not receive an ICD shock in follow-up. ICD therapy appears effective in reducing sudden death mortality in this high risk population.