Mortality in Patients with Implanted Automatic Defibrillators

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Abstract
Patients (52) who survived several arrhythmic cardiac arrests had implantation of an automatic defibrillator along with additional cardiovascular surgery as indicated. The mean follow-up was 14.4 mo. and the longest was 3 yr. In the hospital, the implanted devices identified and reverted 82 episodes of spontaneous and 81 of 99 episodes of induced malignant tachyarrhythmias. There were 62 automatic resuscitations in 17 patients outside the hospital. Twelve patients died; 4 of the deaths were not witnessed. These deaths represent a 22.9% total and 8.5% sudden-death 1-yr mortality rate. Because the expected 1-yr mortality in patients without the automatic defibrillator was calculated to be 48%, there was an estimated 52% decrease in anticipated total deaths. The automatic implantable defibrillator can identify and correct potentially lethal ventricular tachyarrhythmias, leading to a substantial increase in 1-yr survival in properly selected high-risk patients.