INTRODUCTION
Significant progress has been made with the tools in diagnosis and
management of heart failure. One of these advances is the prevention of
sudden cardiac death (SCD) with implantable cardioverter-defibrillators
(ICD).1 Regardless, the long-term mortality rates in
heart failure patients, even with ICD, continue to remain as high as
50% at 10 years.2 These trends are worse in ischemic
(ICM) than in nonischemic (NICM) forms of cardiomyopathy
(CMP).3 It may not be right to simplify the burden of
coronary artery disease (CAD) in patients with cardiomyopathies as a
binary component of epicardial stenosis of more than or less than 70%,
and thus attribute the heart failure to ischemic or nonischemic
aetiologies.4 There is ongoing research on ways to
detect ischemia in cardiomyopathies.5 The studies on
prognosis of concomitant CAD in dilated cardiomyopathies (DCM) are few
and these studies have reported the prognosis of the association of CAD
in only idiopathic DCM. 6-8 Thus, the effect of
moderate CAD coexisting with DCM with definite non-ischemic triggers is
largely unexplored. The resultant phenotype of ‘mixed cardiomyopathy’
might identify clinical and outcome characteristics that are distinct
from ICM or NICM and may impact on clinical management. This phenotype
is gaining attention of late and the prognosis in terms of increased
ventricular arrhythmia burden seems to parallel
ICM.9,10 We aim to study the demographic, clinical,
device therapies and survival characteristics of mixed CMP in a cohort
of patients implanted with a defibrillator.