Frequency and causes of implantable cardioverter-defibrillator therapies: is device therapy proarrhythmic?

The American Journal of Cardiology
Joseph J GermanoMark E Josephson

Abstract

Implantable cardioverter-defibrillator (ICD) shocks diminish patients' quality of life, increase health care resource utilization, and may lead to other adverse sequelae. Better understanding of the factors that lead to ICD therapies, and better strategies to avoid unnecessary therapies, are needed to optimize patient outcomes. Data from major randomized clinical trials involving the use of ICDs and cardiac resynchronization therapy-defibrillator devices were reviewed to determine control group mortality rates, control group sudden death rates, and the frequency of appropriate and inappropriate ICD therapies. In all studies that classified deaths, appropriate ICD therapies outnumbered control group sudden cardiac deaths by a factor of 2 to 3. Some of these episodes can be explained by device programming, by the treatment of potentially unsustained tachycardias, and by errors of episode classification. Another underexplored possibility is that device therapy is proarrhythmic. Reasons for frequent therapies and methods to prevent them are discussed, as well as the notion of device proarrhythmia and the potentially detrimental effects of ICD shocks. These issues clearly affect the overall benefit of device therapy and have importa...Continue Reading

References

May 1, 1985·The American Journal of Cardiology·T D FriehlingT R Engel
Mar 1, 1982·Circulation·L E Hinkle, H T Thaler
Sep 15, 1995·Circulation·S L Pinski, G J Fahy
Feb 1, 1996·Journal of the American College of Cardiology·A E EpsteinF J Venditti
Dec 31, 1997·The New England Journal of Medicine·UNKNOWN Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators
Oct 22, 1998·International Journal of Cardiology·G BorianiB Magnani
Sep 15, 2000·Journal of the American College of Cardiology·S L HigginsD B Meyer
Mar 22, 2002·The New England Journal of Medicine·Arthur J MossUNKNOWN Multicenter Automatic Defibrillator Implantation Trial II Investigators
Sep 6, 2002·Journal of Cardiovascular Electrophysiology·Luis A PiresUNKNOWN Multicenter Unsustained Tachycardia Trial Investigators
Apr 2, 2003·The American Journal of Cardiology·Merritt H RaittUNKNOWN Antiarrhythmics Versus Implantable Defibrillators Investigators
Apr 2, 2003·The New England Journal of Medicine·Bertram PittUNKNOWN Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study Investigators
May 21, 2004·The New England Journal of Medicine·Michael R BristowUNKNOWN Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Investigators
May 21, 2004·The New England Journal of Medicine·Alan KadishUNKNOWN Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators
Nov 10, 2004·Circulation·Paul DorianUNKNOWN SHock Inhibition Evaluation with azimiLiDe (SHIELD) Investigators
Dec 8, 2004·Circulation·Arthur J MossUNKNOWN Multicenter Automatic Defibrillator Implantation Trial-II (MADIT-II) Research Group
Dec 14, 2004·The New England Journal of Medicine·Stefan H HohnloserUNKNOWN DINAMIT Investigators
Apr 27, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Marcelo E Helguera, Sergio L Pinski
Sep 21, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Gunjan ShuklaCharles Haffajee

❮ Previous
Next ❯

Citations

Aug 29, 2009·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Corinna LenzJörg Neuzner
Oct 20, 2012·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·S González-EnríquezJ J Olalla
Sep 3, 2009·Current Heart Failure Reports·Ilknur Can, Venkatakrishna N Tholakanahalli
Mar 8, 2008·Current Treatment Options in Cardiovascular Medicine·Kapil KumarRichard L Verrier
Aug 19, 2008·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Stylianos TzeisPanos E Vardas
Oct 27, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Frieder BraunschweigMartin J Schalij
Jan 7, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Guido H van WelsenesMartin J Schalij
Jun 15, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Angelo AuricchioLaurence Sterns
Jul 26, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Paul A ScottJohn M Morgan
Sep 17, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Johannes B van ReesMartin J Schalij
May 2, 2012·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Antoine LeenhardtUNKNOWN OPERA Registry Investigators
Aug 16, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Marcello DisertoriEloisa Arbustini
Dec 31, 2008·The Journal of Cardiovascular Nursing·Cynthia M Dougherty, Jim Hunziker
Jun 21, 2012·Circulation. Arrhythmia and Electrophysiology·Christine M Albert
Jul 12, 2011·Aging Health·John A Dodson, Mathew S Maurer
Nov 30, 2013·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·T Jared Bunch, Jeffrey L Anderson
May 16, 2014·Herzschrittmachertherapie & Elektrophysiologie·Markus ZarseBernd Lemke
Jun 21, 2014·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Rebecca PerssonKatrin Uhlig
Jul 31, 2014·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·M H MastenbroekM Meine
Jul 25, 2013·Current Cardiology Reports·Faisal M MerchantAntonis A Armoundas
Feb 14, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Mark S KremersJohn Rumsfeld
May 18, 2013·Chest·Niyada NaksukSelcuk Adabag
Jun 1, 2012·Cardiac Electrophysiology Clinics·Marshall W Winner, John D Hummel
Nov 4, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Adolfo FontenlaIgnacio Fernández-Lozano
Mar 13, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Faisal M MerchantAntonis A Armoundas
Mar 10, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Sanjeev P BhavnaniChristopher A Clyne
Jan 27, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Stefan H HohnloserRichard J Cohen
Sep 9, 2008·Progress in Cardiovascular Diseases·Karen E Thomas, Mark E Josephson
Jun 7, 2008·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Andrew E EpsteinUNKNOWN Society of Thoracic Surgeons
Oct 3, 2009·Pacing and Clinical Electrophysiology : PACE·Haris M Haqqani, Harry G Mond
Jun 27, 2007·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·A Selcuk Adabag, Barry J Maron
Jan 30, 2009·Journal of Cardiovascular Electrophysiology·Mikko MinkkinenTuomo Nieminen
Feb 21, 2008·Journal of Cardiovascular Electrophysiology·Alawi A Alsheikh-AliMark S Link
Apr 4, 2008·Journal of Cardiovascular Electrophysiology·Barry J Maron, Paolo Spirito
Oct 28, 2008·Pacing and Clinical Electrophysiology : PACE·Beatrice Brembilla-PerrotYves Juillière
Sep 29, 2007·Journal of Cardiovascular Electrophysiology·Augusto Cardinalli-NetoVanessa C Rodrigues

❮ Previous
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