M. Nakao, T. Temma, H. Yokoshiki, Masaya Watanabe, R. Kamada, H. Hagiwara, Wei-Chieh Lee, T. Koya, T. Kadosaka, T. Koizumi, H. Natsui, K. Kamiya, T. Nagai, T. Anzai
Background: Implantable cardioverter-defibrillator (ICD) shocks are associated with the risk of all-cause death. The association between shock treatment and cardiac prognosis has not been elucidated in patients with ventricular arrhythmias (VAs). We aimed to investigate the adverse cardiac effects of ICD shocks in patients with VAs. Methods: We retrospectively investigated 137 patients with VA from 548 consecutive patients who had ICD implants between December 2000 and August 2018. They were divided into a shock group with at least one shock and an anti-tachycardia pacing (ATP) group with only ATP. The primary outcome was cardiac death, ventricular assist device (VAD) implantation, and inotrope-dependent heart failure. We also investigated death from any cause and cardiac death as secondary outcomes. Results: During the observation period (median 65.0, 37.5–93.5 months), 30 patients (22%) developed a primary outcome: 21 (15%) cardiac death, 4 (3%) VAD implantation, 5 (4%) inotrope-dependent heart failure. All-cause death was observed in 39 patients. The cumulative incidence of the primary outcome was significantly higher in the shock group than in the ATP group (log-rank p = 0.012). The incidence of secondary outcomes was also higher in the shock group than in the ATP group (logrank p = 0.005 for cardiac death and 0.006 for all-cause death). In the multivariate Cox proportional hazards regression analysis, at least one shock was related to the risk of the primary outcome (hazard ratio 2.57 [1.06–7.69], p = 0.04). Conclusions: ICD shocks are associated with adverse cardiac events in patients with VA.
{"title":"Cardiac Prognostic Impact of Implantable Cardioverter-Defibrillator Shock in Patients with Ventricular Arrhythmias","authors":"M. Nakao, T. Temma, H. Yokoshiki, Masaya Watanabe, R. Kamada, H. Hagiwara, Wei-Chieh Lee, T. Koya, T. Kadosaka, T. Koizumi, H. Natsui, K. Kamiya, T. Nagai, T. Anzai","doi":"10.2139/ssrn.3939436","DOIUrl":"https://doi.org/10.2139/ssrn.3939436","url":null,"abstract":"Background: Implantable cardioverter-defibrillator (ICD) shocks are associated with the risk of all-cause death. The association between shock treatment and cardiac prognosis has not been elucidated in patients with ventricular arrhythmias (VAs). We aimed to investigate the adverse cardiac effects of ICD shocks in patients with VAs. Methods: We retrospectively investigated 137 patients with VA from 548 consecutive patients who had ICD implants between December 2000 and August 2018. They were divided into a shock group with at least one shock and an anti-tachycardia pacing (ATP) group with only ATP. The primary outcome was cardiac death, ventricular assist device (VAD) implantation, and inotrope-dependent heart failure. We also investigated death from any cause and cardiac death as secondary outcomes. Results: During the observation period (median 65.0, 37.5–93.5 months), 30 patients (22%) developed a primary outcome: 21 (15%) cardiac death, 4 (3%) VAD implantation, 5 (4%) inotrope-dependent heart failure. All-cause death was observed in 39 patients. The cumulative incidence of the primary outcome was significantly higher in the shock group than in the ATP group (log-rank p = 0.012). The incidence of secondary outcomes was also higher in the shock group than in the ATP group (logrank p = 0.005 for cardiac death and 0.006 for all-cause death). In the multivariate Cox proportional hazards regression analysis, at least one shock was related to the risk of the primary outcome (hazard ratio 2.57 [1.06–7.69], p = 0.04). Conclusions: ICD shocks are associated with adverse cardiac events in patients with VA.","PeriodicalId":260616,"journal":{"name":"BioRN EM Feeds","volume":"483 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116536267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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