Abstract 15312: Predictors for Defibrillator Therapy in Modern Urban Cohort of Patients With Heart Failure

IntroductionAfrican Americans (AA) have been under-represented in landmark ICD trials and the impact of co-morbidities and medications on sudden cardiac death (SCD) and ventricular arrhythmias is not well established this population.HypothesisRisk factors for ventricular events in a predominantly AA population with heart failure who may differ from general US population.MethodsWe conducted a single-center retrospective chart review. Implant, interrogation and demographics data from January 2013 to January 2018 were identified. Patients with hereditary arrhythmias and those implanted for secondary prophylaxis of SCD were excluded from the analysis. Appropriate ICD events were defined as either non-sustained ventricular arrhythmia >170 bpm, ATP therapy or shock.ResultsOf 160 patients identified, 90% were AA, 59% were male and 48% had heart failure attributed to coronary artery disease. The average EF was 24.3±7.8%, average follow-up was 27.2±1.37 months. Of those 18% had appropriate ICD events and 12% inappropriate therapy. Logistic regression analysis identified absence of β-blocker therapy (OR 10.33 (CI 2.781-38.399 p=0.002) and male gender (OR 2.45 CI 0.98-6.14 p=0.049) as predictors for appropriate ICD events. No clinical variables predicted inappropriate ICD events.ConclusionsIn our predominantly AA cohort, rate of appropriate and inappropriate ICD events was low. Male gender and absence of β-blocker therapy was associated with increased rate of ICD events as seen in Caucasian patients. Interestingly neither presence of atrial fibrillation nor age were predictive of inappropriate shocks as suggested in prior studies.