Supervivencia en pacientes con falla cardiaca y desfibrilador automático implantable en una unidad de electrofisiología de Pereira, Colombia: Survival in patients with heart failure and implantable cardioverter-defibrillator in an electrophysiological unit in Pereira, Colombia

Introduction: Implantable cardioverter defibrillator therapy seeks to prevent sudden cardiac death by collapsing malignant arrhythmias. Objective: to identify the clinical variables that impact on the mortality of patients with heart failure implanted with cardioverter defibrillator. Material y methods: Retrospective cohort study. Patients with a defibrillator implant from the year 2010 to the year 2012 were included, with functional device, clinical history and availability of follow-up until the first quarter of 2014. Results: A total of 30 patients were included, with a 77% survival at four years of follow-up. 82.7% of the patients presented with ischemic heart disease and the mean left ventricular ejection fraction was 27.8 ± 6.3. The mean time of use of the defibrillator was 2.1 years, the reported mayor danger rate was 6% for days 759 and 760. An association was found between a QRS mayor duration at 120 ms (HR = 7.7, 90% CI = 1.77-33.6, p = 0.022), atrial fibrillation (HR = 4.2, 90% CI = 1.13-15.68, p = 0.072), and beta- blockers (HR = 0.15, 90% CI = 0.03-0.64, p = 0.031) with survival time. Discussion: The prevention of death is conditioned by pharmacological optimization, as well as structural and electrical conduction anomalies, so the monitoring and adjustment of pharmacological therapy should be increased. Conclusions: the use of beta-blockers in patients with atrial fibrillation and QRS duration greater than 120 ms is a protective factor.