What is the clinical evidence from this study?

Study design: Observational. Population: Patients with implantable cardioverter defibrillators (ICD) and ventricular arrhythmias (n=70). Intervention: Implantable cardioverter defibrillators (ICD) vs. Comparison between groups with different NYHA classes based on functional capacity. Primary outcome: Frequency of ventricular arrhythmia episodes (sustained VT or VF episodes) during follow-up (p=0.019, p=0.019).

What does this research mean for the field?

Patients with NYHA class III heart failure experience a significantly higher frequency of ventricular arrhythmia episodes requiring ICD therapy compared to patients in lower NYHA classes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the relationship between ICD episode frequency and functional capacity in heart failure patients classified by NYHA.

February 26, 2026Eskisehir Medical Journal Eskisehir City Hospital0 citationsOpen Access

The Relationship Between Episode Frequency and Functional Capacity in Patients Treated With Implantable Cardioverter Defibrillators

SSSedat Sakalli EPEsra Polat EDEngin Dondurmaci

Key Result

Patients with NYHA class III heart failure had a significantly higher frequency of ventricular arrhythmia episodes (25.33±27.63) compared to patients in NYHA class I-II, II, and II-III (8.36±21.18), p=0.019.

Key Points

To evaluate the relationship between ICD episode frequency and functional capacity in heart failure patients classified by NYHA.
Retrospective review of 70 patients with ICD implanted from January 1998 to April 2004
Grouping patients based on NYHA classification into Group A (Class I-II, II, II-III) and Group B (Class III)
Analysis of demographic data, echocardiography findings, ejection fractions, and ICD episode frequency
Mean follow-up period was 3.08±1.31 years
Total of 791 episodes of sustained ventricular tachycardia or ventricular fibrillation noted
Frequency of episodes higher in NYHA class III (Group B) compared to Group A (25.33±27.63 vs 8.36±21.18, p=0.019)

Study Design

Type

Observational (n=70)

Multicenter

Structured PICO

Does NYHA class III heart failure increase the frequency of ventricular arrhythmia episodes in patients treated with implantable cardioverter defibrillators?

Population

70 consecutive patients with complete data who had implantable cardioverter defibrillators (ICD) implanted according to guideline recommendations. Mean age 64.6 years, 90% male, based in Turkey. Etiology included ischemic cardiomyopathy (75.7%), dilated cardiomyopathy (18.6%), and hypertrophic cardiomyopathy (5.7%). Mean EF was 34.7%. Patients were categorized by NYHA class: I-II (2.9%), II (21.4%), II-III (58.6%), and III (17.1%).

Intervention

Implantable cardioverter defibrillator (ICD) implantation (64 single-chamber, 6 dual-chamber) in patients with NYHA Class III heart failure (Group B).

Comparator

Patients with NYHA Class I-II, II, and II-III heart failure (Group A) who also received implantable cardioverter defibrillators.

Outcome

Frequency of appropriately treated episodes of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) per patient.hard clinical

In patients with ICDs, NYHA class III functional capacity is associated with a significantly higher frequency of ventricular arrhythmia episodes compared to lower NYHA classes, suggesting greater device utilization in this subgroup.

Main Result

Effect estimate: p=0.019

Absolute Event Rate: 25.33% vs 8.36%

p-value: p=0.019

Limitations

Retrospective observational design
Functional capacity was not assessed with objective measures such as 6-minute walk test
Study period was before availability of newer heart failure medications

Abstract

Introduction: Left ventricular ejection fraction (EF) is an important parameter for determining the frequency of ventricular arrhythmia episodes in patients treated with implantable cardioverter defibrillators (ICD). However, the relationship between heart failure and ICD episode frequency is controversial. This study aimed to evaluate the relationship between ICD episode frequency and functional capacity in patients classified according to the New York Heart Association (NYHA). Methods: The frequency of ventricular arrhythmia episodes was examined in patients who had a ICD implanted between January 1998 and April 2004. Seventy consecutive patients were retrospectively reviewed. Class I-II, II, and II-III patients were grouped into Group A, and Class III patients were grouped into Group B. The patients' demographic data, echocardiography findings, EFs, NYHA clinical status, indications for ICD implantation, and ICD episodes were examined. Results: The mean follow-up period for patients was 3.08±1.31 years. Two patients were NYHA class I-II, 15 patients were NYHA class II, 41 patients were NYHA class II-III, and 12 patients were NYHA class III. A total of 791 appropriately treated episodes of sustained ventricular tachycardia or ventricular fibrillation were observed in 70 patients. When these episodes were analyzed according to NYHA group, the frequency of ventricular arrhythmia episodes was higher in the Group B patient group (8.36±21.18 vs 25.33±27.63, p=0.019). Conclusions: NYHA class III heart failure is an easily assessable clinical measure and an important risk factor for the need for ICD treatment of ventricular arrhythmias. The rate of benefit from ICD treatment is higher in patients in the NYHA class III group.

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