Implantation of the cardioverter-defibrillator: Cuban Registry (2017)

Abstract

Introduction: The implantable cardioverter-defibrillator (ICD) has proven useful in the primary and secondary prevention of sudden cardiac death. The increase of its use motivates interest on its effectiveness outside the clinical trials. The first registration of an ICD implantation in Cuba is performed. Objective: To know the current situation of an ICD implantation in Cuba, regarding clinical data, indication, type of implant, device and complications of the procedure. Method: The registration’s data were obtained through the collection form, which was completed voluntarily by each implantation team during or after the implant. Results: The total number of implants was 121, and the rate of 10.76 per million inhabitants. The procedure was performed in 5 medical institutions in the country, and 69.4% of the devices were implanted at the «Instituto de Cardiología y Cirugía Cardiovascular». The mean age was 58.05 ± 14.83, with a predominance of men (71.1%). The 52.1% were primo-implantation, dual-chamber devices represented 43.8% and triple-chamber 16.5%. In the primoimplants predominated patients with ejection fraction ≤35% (42.9%), in sinus rhythm (92.1%), with functional class III-IV (49.2%) and ischemic heart disease (41.3%). The 79.4% of the first implants were secondary prevention, and sudden death (42.9%), the most common clinical presentation. Complications were infrequent (4.1%) and the hematoma predominated. Conclusions: The implantation rate of the ICD per million inhabitants is comparable with that of Latin American countries. The implants of triple-chamber systems and in primary prevention are still modest.