Occurrence of implantable defibrillator events in patients with syncope and nonischemic dilated cardiomyopathy

Syncope is a known predictor of poor outcome and sudden death in patients with a nonischemic dilated cardiomyopathy.(1,2) Electrophysiologic testing often reveals no inducible sustained ventricular arrhythmias, and has a poor predictive value in this patient population.(3-6) Implantable cardioverter-defibrillators (ICDs) are frequently recommended in these patients. However, there are limited long-term data regarding the frequency of appropriate defibrillator therapy for sustained ventricular arrhythmias in patients with nonischemic dilated cardiomyopathies presenting with sustained ventricular arrhythmias or syncope.(6-10) The present study examines the frequency of appropriate and inappropriate ICD therapy in patients with dilated cardiomyopathy presenting with syncope, without documented clinical sustained ventricular arrhythmias.