Arrhythmia and Survival Outcomes among Black and White Patients with a Primary Prevention Defibrillator.

Black patients have a higher risk of developing non-ischemic cardiomyopathy (NICM) but are under-represented in clinical trials of implantable cardioverter defibrillators (ICD). Therefore, data on disparities in the presentation and outcomes in this population are limited.This analysis represents the largest group of self-identified Black patients implanted in the U.S. with an ICD for primary prevention with adjudication of all arrhythmic events. In patients with a NICM, self-identified Black compared to White patients experienced an increased incidence and burden of ventricular tachyarrhythmia, atrial tachyarrhythmia, and ICD therapies. These differenced were not observed in Black vs White patients with ischemic cardiomyopathy (ICM).Although Black patients with NICM were implanted at a significantly younger age (57±12 vs 62±12 years), they experienced a 2-fold higher rate of all-cause mortality during a mean follow up of 3 years compared with White patients.These findings highlight the need for early intervention with an ICD, careful monitoring, and intensification of heart failure and antiarrhythmic therapies among Black patients with NICM.