Muñoz Aguilera, RobertoBriongos Figuero, Sem2023-06-162023-06-162022-01-25https://hdl.handle.net/20.500.14352/3406Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 14-10-2021El desfibrilador automático implantable (DAI) ha demostrado ser una terapia eficaz en la prevención de la muerte súbita cardiaca (MSC). En los últimos 20 años, múltiples ensayos clínicos aleatorizados han demostrado el beneficio que obtienen los pacientes de alto riesgo, tras el implante de un DAI. En los pacientes con insuficiencia cardíaca (IC) y fracción de eyección del ventrículo izquierdo (FEVI) deprimida, el DAI ha demostrado una reducción dela mortalidad total de un 20%, gracias principalmente a una reducción relativa del 54% en el riesgo de MSC. Sin embargo, existen poblaciones infrarrepresentadas en los ensayos clínicos diseñados para analizar del beneficio del DAI. Por otro lado, el seguimiento a largo plazo delos ensayos pivotales ha puesto de manifiesto que el beneficio del DAI se mantiene a largo plazo y que los pacientes que más descargas reciben tienen un peor pronóstico...The implantable cardioverter defibrillator (ICD) is a leading therapy in preventing sudden cardiac death (SCD). For the past 20 years, several randomized clinical trials have demonstrated the benefit that high-risk patients obtain after an ICD implantation. The ICD therapy is related to a 20% reduction in all-cause death, mainly driven by a 54% relative reduction in the risk of SCD, among heart failure (HF) patients with reduced left ventricle ejection fraction (LVEF). However, there are populations that were under represented inclinical trials. On the other hand, data extracted from the extended follow-up of randomized clinical trials demonstrated that the ICD benefit is maintained after long-term follow-up. Moreover, patients at higher risk of an ICD shock have also worse prognosis. As the ICD therapy is related to some adverse events it is necessary to understand the characteristics of the Spanish population receiving an ICD and to describe prognosis after long-term follow-up. The analysis of the Spanish population receiving an ICD, stratified according to the underlying heart disease and ICD indication, will be useful to compare the incidence of arrhythmic events, ICD interventions and all-cause death, as well as to describe patients´ subgroups that obtain more benefit after an ICD implant...spadoctoral thesisopen access616.12-008.46(043.2)Insuficiencia cardíacaHeart failureCardiología3205.01 Cardiología