Verrier, E.F.B.J. (2026) Heeft een ICD toegevoegde waarde na succesvolle revascularisatie? Een retrospectieve cohortstudie bij patiënten met een out-of-hospital cardiac arrest op basis van acuut coronair syndroom. thesis, Medicine.
Full text available on request.Abstract
Background Survivors of out- of- hospital cardiac arrest (OHCA) caused by acute coronary syndrome (ACS) are commonly treated with coronary revascularization. Although current guidelines do not recommend routine implantable cardioverter defibrillator (ICD) implantation after OHCA in the setting of acute transmural ischemia, especially if successful treatment of the underlying ischemic cause has taken place, clinical practice is more complex, and ICD implantation is sometimes performed based on individual clinical judgement. It remains unclear to what extent ICD implantation as secondary prevention improves clinical outcomes in the patient population. This study is aimed to evaluate the association between ICD implantation, life threatening ventricular arrhythmias, mortality and cardiovascular complications. Methods In this retrospective single- center cohort study, patients admitted between January 2018 and April 2026 following OHCA caused by ACS and treated with PCI or CABG were included. The primary endpoint was a composite of sudden cardiac death in the non ICD group and first appropriate ICD shock in the ICD group. Secondary outcomes included MACE and patient characteristics associated with the primary endpoint. Results A total of 287 patients were included, of whom 86 (30%) received an ICD. Median follow- up was 213.5 weeks. The primary endpoint occurred significantly more frequently in the ICD group (p<0.001). After adjustment for relevant confounding factors, ICD implantation remained associated with the primary endpoint (HR 27.8; 95% CI 5.94-130). No significant differences were observed in MACE. All- cause mortality was higher in the ICD group (p=0.046). Conclusion Patients receiving an ICD more frequently reached the primary endpoint during follow-up. This finding may be explained by a more severe cardiovascular risk profile. At the same time, high survival rates were observed in the non- ICD group. Further prospective studies are required to clarify the role of ICD implantation following revascularization in OHCA survivors.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Dessel, P.F.H.M. van and Opstal, J.M. van |
| Faculty: | Medical Sciences |
| Date Deposited: | 23 Oct 2026 09:06 |
| Last Modified: | 23 Oct 2026 09:06 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3983 |
Actions (login required)
 |
View Item |