Background: There is no clear consensus on whether to routinely insert a primary prevention defibrillator in patients receiving CRT Improvement of cardiac status may reduce the likelihood of ventricular arrhythmia and therefore the need for an ICD This is especially true in patients with a non-ischaemic cardiomyopathy The risk of inappropriate therapy must also be taken into account Our aim was to review the incidence of appropriate and inappropriate therapy in patients undergoing CRT-D implantation under active follow up Method: Patients with an active CRT-D were sampled from the PaceArt database Those who received a primary prevention device were included in the analysis Baseline data and therapy received was collected Results: There were 78 patients in our analysis 11(14%) had an ischaemic cardiomyopathy, 64 (82%) had a non-ischemic cardiomyopathy and 3(4%) were of mixed aetiology The average age at implant was 63 years 27(35%) were female The mean EF at implant was 23% In total, 19 (24%) patients received therapy 4(5%) received inappropriate therapy, 1 received an inappropriate shock 45% of ischaemic cardiomyopathy patients received therapy vs 22% of non-ischaemic patients There were no cases of inappropriate therapy in ischaemic patients Conclusion: The incidence of appropriate therapy is higher with ischaemic cardiomyopathy than with non-ischaemic cardiomyopathy for patients in our data set The number of patients receiving inappropriate therapy was low This may help with device selection and inform patients of potential risks and benefits
Defibrillator Therapy in Patients Receiving a Primary Prevention CRT-D Device: The Wellington Experience