Prediction of appropriate defibrillator therapy in heart failure patients treated with cardiac resynchronization therapy

The American Journal of Cardiology
Osama I I SolimanMarcel L Geleijnse

Abstract

The necessity of implantable cardioverter-defibrillator (ICD) implantation in patients with systolic heart failure (HF) who undergo cardiac resynchronization therapy (CRT) may be questioned. The aim of this study was to identify patients at low risk for sustained ventricular arrhythmia. One hundred sixty-nine consecutive patients with HF (mean age 60 +/- 12 years, 125 men, 73% in New York Heart Association class III) referred for CRT and prophylactic, primary prevention ICD implantation underwent baseline clinical and echocardiographic assessment and regular device follow-up. The primary study end point was appropriate ICD therapy. During a mean follow-up period of 654 +/- 394 days, 35 patients (21%) had sustained ventricular arrhythmias requiring appropriate ICD therapy. Of the 3 patients who experienced sudden cardiac death, 2 had been treated with appropriate ICD therapy before sudden cardiac death. In a multivariate model, only history of nonsustained ventricular tachycardia (p = 0.001), a severely (<20%) decreased left ventricular ejection fraction (p = 0.001), and digitalis therapy (p = 0.08) independently predicted appropriate ICD therapy. Patients with 0 (n = 46), 1 (n = 36), 2 (n = 73), and 3 (n = 14) risk factors for ...Continue Reading

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Citations

Oct 12, 2012·European Heart Journal·Valentina KutyifaHelmut Klein
Jul 13, 2012·Circulation. Arrhythmia and Electrophysiology·Daniel J FriedmanE Kevin Heist
Jan 23, 2016·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·I A H Ter HorstM Meine
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Jan 25, 2017·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Joseph B SelvanayagamAndrew D McGavigan
Jul 2, 2017·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·Sérgio BarraSharad Agarwal
Sep 25, 2017·Journal of Cardiovascular Pharmacology and Therapeutics·George S MinaPaari Dominic

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