Relationship between age and inappropriate implantable cardioverter-defibrillator therapy in MADIT-RIT (Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy).

Autor:	Biton Y; Heart Research Follow(-)up Program, Division of Cardiology, Department of Medicine at the University of Rochester Medical Center, Rochester, New York; Heart Institute, Sheba Medical Center, Ramat Gan, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel,. Electronic address: yitschak.biton@heart.rochester.edu., Huang DT; Heart Research Follow(-)up Program, Division of Cardiology, Department of Medicine at the University of Rochester Medical Center, Rochester, New York; Heart Institute, Sheba Medical Center, Ramat Gan, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Goldenberg I; Heart Research Follow(-)up Program, Division of Cardiology, Department of Medicine at the University of Rochester Medical Center, Rochester, New York; Heart Institute, Sheba Medical Center, Ramat Gan, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Rosero S; Heart Research Follow(-)up Program, Division of Cardiology, Department of Medicine at the University of Rochester Medical Center, Rochester, New York., Moss AJ; Heart Research Follow(-)up Program, Division of Cardiology, Department of Medicine at the University of Rochester Medical Center, Rochester, New York., Kutyifa V; Heart Research Follow(-)up Program, Division of Cardiology, Department of Medicine at the University of Rochester Medical Center, Rochester, New York., McNitt S; Heart Research Follow(-)up Program, Division of Cardiology, Department of Medicine at the University of Rochester Medical Center, Rochester, New York., Strasberg B; Cardiology Department(,) Rabin Medical Center, Petah Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Zareba W; Heart Research Follow(-)up Program, Division of Cardiology, Department of Medicine at the University of Rochester Medical Center, Rochester, New York., Barsheshet A; Heart Research Follow(-)up Program, Division of Cardiology, Department of Medicine at the University of Rochester Medical Center, Rochester, New York; Cardiology Department(,) Rabin Medical Center, Petah Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Jazyk:	angličtina
Zdroj:	Heart rhythm [Heart Rhythm] 2016 Apr; Vol. 13 (4), pp. 888-93. Date of Electronic Publication: 2015 Dec 19.
DOI:	10.1016/j.hrthm.2015.12.032
Abstrakt:	Background: There is limited data regarding the relationship between age and inappropriate therapy among patients with an implantable cardioverter-defibrillator (ICD) and resynchronization therapy. Objectives: We aimed to investigate this relationship and the effect of ICD programming on inappropriate therapy by age. Methods: In the Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT) 1500 patients were randomized to 3 ICD programming arms: (A) conventional with ventricular tachycardia (VT) therapy ≥170; (B) high-rate cutoff with VT therapy ≥200, and (C) prolonged 60-second delay for VT therapy ≥170. We investigated the relationship between age, the risk of inappropriate ICD therapy (including antitachycardia pacing [ATP] or shock), and ICD programming. Results: Cumulative incidence function Kaplan-Meier graphs showed an inverse relationship between increasing quartiles of age (Q1: ≤55, Q2: 56-64, Q3: 65-71, and Q4: ≥72 years) and the risk for inappropriate therapy. Multivariate analyses showed that each increasing decade of life was associated with 34% (P < .001), 27% (P < .001), and 26% (P < .001) reduction in the risk of inappropriate shock, inappropriate ATP, and any inappropriate therapy, respectively. Treatment arms B and C as compared with arm A were associated with a significant reduction in the risk of inappropriate therapies across all age quartiles (P < .001 for all). Conclusions: Among patients with a primary prevention indication for an ICD, there is an inverse relationship between age and inappropriate ICD therapy. Innovative ICD programming of high-rate cutoff or prolonged delay for VT therapy is associated with significant reductions in inappropriate therapy among all age groups. (Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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