LVEF improvement for many with primary prevention ICDs

(HealthDay)—Forty percent of patients with primary prevention implantable cardioverter-defibrillators (ICDs) experience improvement in left ventricular ejection fraction (LVEF), according to a study published in the Aug. 4 issue of the Journal of the American College of Cardiology.

Yiyi Zhang, Ph.D., from the Johns Hopkins University Bloomberg School of Public Health in Baltimore, and colleagues conducted a prospective cohort study involving 538 patients with repeated LVEF assessments after ICD implantation for primary prevention of sudden cardiac death. Participants were followed for a mean of 4.9 years.

The researchers found that LVEF decreased in 13.0 percent of patients, improved in 40.0 percent, and was unchanged in 47.0 percent during follow-up. For patients with versus without improved LVEF, the hazard ratios were 0.33 and 0.29 for mortality and appropriate shock, respectively. One-quarter of patients showed improvement in LVEF to >35 percent during follow-up, and there was a decrease in, but not elimination of, their risk of appropriate shock.

"Among primary prevention ICD patients, 40.0 percent had an improved LVEF during follow-up and 25 percent had LVEF improved to >35 percent," the authors write. "Changes in LVEF were inversely associated with all-cause mortality and appropriate shocks for ventricular tachyarrhythmias."

Several authors disclosed financial ties to the medical technology industry.