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Carrick RT, De Marco C, Gasperetti A, Bosman LP, Gourraud JB, Trancuccio A, Mazzanti A, Murray B, Pendleton C, Tichnell C, Tandri H, Zeppenfeld K, Wilde AAM, Davies B, Seifer C, Roberts JD, Healey JS, MacIntyre C, Alqarawi W, Tadros R, Cutler MJ, Targetti M, Calò L, Vitali F, Bertini M, Compagnucci P, Casella M, Dello Russo A, Cappelletto C, De Luca A, Stolfo D, Duru F, Jensen HK, Svensson A, Dahlberg P, Hasselberg NE, Di Marco A, Jordà P, Arbelo E, Moreno Weidmann Z, Borowiec K, Delinière A, Biernacka EK, van Tintelen JP, Platonov PG, Olivotto I, Saguner AM, Haugaa KH, Cox M, Tondo C, Merlo M, Krahn AD, te Riele ASJM, Wu KC, Calkins H, James CA, Cadrin-Tourigny J. Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe. Eur Heart J 2024; 45:538-548. [PMID: 38195003 PMCID: PMC11024811 DOI: 10.1093/eurheartj/ehad799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 09/14/2023] [Accepted: 11/21/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND AND AIMS Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death (SCD) in arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to identify cross-continental differences in utilization of primary prevention ICDs and survival free from sustained ventricular arrhythmia (VA) in ARVC. METHODS This was a retrospective analysis of ARVC patients without prior VA enrolled in clinical registries from 11 countries throughout Europe and North America. Patients were classified according to whether they received treatment in North America or Europe and were further stratified by baseline predicted VA risk into low- (<10%/5 years), intermediate- (10%-25%/5 years), and high-risk (>25%/5 years) groups. Differences in ICD implantation and survival free from sustained VA events (including appropriate ICD therapy) were assessed. RESULTS One thousand ninety-eight patients were followed for a median of 5.1 years; 554 (50.5%) received a primary prevention ICD, and 286 (26.0%) experienced a first VA event. After adjusting for baseline risk factors, North Americans were more than three times as likely to receive ICDs {hazard ratio (HR) 3.1 [95% confidence interval (CI) 2.5, 3.8]} but had only mildly increased risk for incident sustained VA [HR 1.4 (95% CI 1.1, 1.8)]. North Americans without ICDs were at higher risk for incident sustained VA [HR 2.1 (95% CI 1.3, 3.4)] than Europeans. CONCLUSIONS North American ARVC patients were substantially more likely than Europeans to receive primary prevention ICDs across all arrhythmic risk strata. A lower rate of ICD implantation in Europe was not associated with a higher rate of VA events in those without ICDs.
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MESH Headings
- Humans
- Defibrillators, Implantable/adverse effects
- Arrhythmogenic Right Ventricular Dysplasia/complications
- Arrhythmogenic Right Ventricular Dysplasia/epidemiology
- Arrhythmogenic Right Ventricular Dysplasia/therapy
- Retrospective Studies
- Arrhythmias, Cardiac/epidemiology
- Arrhythmias, Cardiac/therapy
- Arrhythmias, Cardiac/etiology
- Death, Sudden, Cardiac/epidemiology
- Death, Sudden, Cardiac/prevention & control
- Death, Sudden, Cardiac/etiology
- Risk Factors
- North America/epidemiology
- Europe/epidemiology
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Affiliation(s)
- Richard T Carrick
- Heart and Vascular Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Corrado De Marco
- Cardiovascular Genetics Centre, Montreal Heart Institute, Université de Montréal, 5000 rue Bélanger, Montréal, Québec H1T 1C8, Canada
| | - Alessio Gasperetti
- Heart and Vascular Institute, Johns Hopkins University, Baltimore, MD, USA
- Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Laurens P Bosman
- Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart)
| | - Jean-Baptiste Gourraud
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart)
- Department of Cardiology, Centre Hospitalier Universitaire Nantes, Nantes, France
| | | | - Andrea Mazzanti
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri (IRCCS), Pavia, Italy
| | - Brittney Murray
- Heart and Vascular Institute, Johns Hopkins University, Baltimore, MD, USA
| | | | - Crystal Tichnell
- Heart and Vascular Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Harikrishna Tandri
- Heart and Vascular Institute, Johns Hopkins University, Baltimore, MD, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Katja Zeppenfeld
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Arthur A M Wilde
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart)
- Amsterdam UMC, Heart Center Department of Cardiology, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, University of Amsterdam, Amsterdam, The Netherlands
| | - Brianna Davies
- Center for Cardiac Innovation, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Colette Seifer
- St.Boniface Hospital, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jason D Roberts
- Hamilton Health Sciences, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, Ontario, Canada
| | - Jeff S Healey
- Hamilton Health Sciences, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Ciorsti MacIntyre
- Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Wael Alqarawi
- Department of Cardiac Sciences, College of Medicine, King Saudi University, Riyadh, Saudi Arabia
- Division of Cardiology, University of Ottawa Heart Institute, University of Ottawa, Ottawa, Canada
| | - Rafik Tadros
- Cardiovascular Genetics Centre, Montreal Heart Institute, Université de Montréal, 5000 rue Bélanger, Montréal, Québec H1T 1C8, Canada
| | - Michael J Cutler
- Intermountain Medical Center, Intermountain Medical Center Heart Institute, Murray, UT, USA
| | - Mattia Targetti
- Cardiomyopathy Unit, Careggi Hospital and Meyer Children’s Hospital IRCCS, Florence, Italy
| | - Leonardo Calò
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | - Francesco Vitali
- Cardiology Unit, Sant’Anna University Hospital, University of Ferrara, Ferrara, Italy
| | - Matteo Bertini
- Cardiology Unit, Sant’Anna University Hospital, University of Ferrara, Ferrara, Italy
| | - Paolo Compagnucci
- Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti, Ancona, Italy
| | - Michela Casella
- Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti, Ancona, Italy
| | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti, Ancona, Italy
| | - Chiara Cappelletto
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart)
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste, Trieste, Italy
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden
| | - Antonio De Luca
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart)
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste, Trieste, Italy
| | - Davide Stolfo
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart)
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste, Trieste, Italy
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden
| | - Firat Duru
- Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland
| | - Henrik K Jensen
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart)
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus N, Denmark
| | - Anneli Svensson
- Department of Cardiology, Linköping University Hospital, Linköping, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Pia Dahlberg
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Nina E Hasselberg
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway
| | - Andrea Di Marco
- Arrhythmia Unit, Department ofCardiology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
- BioHeartCardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Paloma Jordà
- Cardiovascular Genetics Centre, Montreal Heart Institute, Université de Montréal, 5000 rue Bélanger, Montréal, Québec H1T 1C8, Canada
- Arrhythmia Section, Department of Cardiology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Elena Arbelo
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart)
- Arrhythmia Section, Department of Cardiology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- Institut d'Investigació August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | | | - Karolina Borowiec
- Department of Congenital Heart Diseases, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland
- Outpatient Department of Genetic Arrhythmias, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland
| | - Antoine Delinière
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart)
- Department of Cardiology, National Reference Center for Inherited Arrhythmias of Lyon, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France
- University of Lyon, Claude Bernard Lyon 1 University, MeLiS, CNRS UMR 5284, INSERM U1314, Institut NeuroMyoGène, Lyon, France
| | - Elżbieta K Biernacka
- Department of Congenital Heart Diseases, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland
- Outpatient Department of Genetic Arrhythmias, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland
| | - J Peter van Tintelen
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart)
- Department of Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Pyotr G Platonov
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden
| | - Iacopo Olivotto
- Cardiomyopathy Unit, Careggi Hospital and Meyer Children’s Hospital IRCCS, Florence, Italy
| | - Ardan M Saguner
- Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland
| | - Kristina H Haugaa
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway
| | - Moniek Cox
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Claudio Tondo
- Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino, IRCCS, University of Milan, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Marco Merlo
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart)
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste, Trieste, Italy
| | - Andrew D Krahn
- Center for Cardiac Innovation, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anneline S J M te Riele
- Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart)
| | - Katherine C Wu
- Heart and Vascular Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Hugh Calkins
- Heart and Vascular Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Cynthia A James
- Heart and Vascular Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Julia Cadrin-Tourigny
- Cardiovascular Genetics Centre, Montreal Heart Institute, Université de Montréal, 5000 rue Bélanger, Montréal, Québec H1T 1C8, Canada
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