Performance evaluation of implantable cardioverter-defibrillators with SmartShock technology in patients with inherited arrhythmogenic diseases.

Autor: Auricchio A; Division of Cardiology, Istituto Cardiocentro Ticino, Lugano, Switzerland. Electronic address: angelo.auricchio@eoc.ch., Sterns LD; Vancouver Island Arrhythmia Clinic, Victoria, BC, Canada., Schloss EJ; The Christ Hospital, Cincinnati, OH, USA., Gerritse B; Medtronic Bakken Research Center, Maastricht, Netherlands., Lexcen DR; Medtronic plc, Mounds View, MN, USA., Molan AM; Medtronic plc, Mounds View, MN, USA., Kurita T; Division of Cardiovascular Center, Kindai University, School of Medicine, Japan.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2022 Mar 01; Vol. 350, pp. 36-40. Date of Electronic Publication: 2022 Jan 06.
DOI: 10.1016/j.ijcard.2022.01.007
Abstrakt: Background: Patients with inherited arrhythmogenic diseases (IADs) are often prescribed preventative implantable cardioverter-defibrillators (ICDs) to manage their increased sudden cardiac arrest risk. However, it has been suggested that ICDs in IAD patients may come with additional risk. We aimed to leverage the PainFree SmartShock Technology dataset to compare inappropriate therapies, appropriate therapies, mortality, and complications in patients with and without IAD.
Methods: This retrospective analysis included extracted, physician-adjudicated, arrhythmic episodes from ICD devices. The incidence of arrhythmic events was estimated with the Kaplan-Meier method using the log-rank test. Cox proportional hazards regression was used to estimate hazard ratios (HRs) with their 95% confidence intervals (CIs).
Results: Of the 1699 ICD patients, 77 patients (4.5%) had IAD. Incidence of inappropriate shock was similar in both patients with (3.2% at 24 months) and without (3.8% at 24 months) IAD (HR: 0.80, CI: 0.19-3.30, p = 0.76). In a multivariable analysis IAD was not significantly associated with reduced mortality (HR: 0.64, CI: 0.08-4.80, p = 0.66). The rates of complications were numerically lower in patients with IAD vs without (8.8% vs 9.6% at 24 months respectively), but not statistically significant (HR: 0.83, CI: 0.20-3.38, p = 0.79).
Conclusions: IAD patients showed a very low annual rate of inappropriate therapy. This suggests that newer algorithms, such as the SST algorithm, are equally good at identifying and treating life-threatening arrhythmias in patients regardless of whether they have IAD.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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