Clinical Predictors of Appropriate Implantable Cardioverter-Defibrillator Therapies in Primary Prevention: A Retrospective Study
Autor: | Andrea Magnani, Gabriele Dell'Era, Eraldo Occhetta, Chiara Devecchi, Paolo Marino, Francesco Rametta, Vincenzo Alessandro Galiffa |
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Rok vydání: | 2017 |
Předmět: |
medicine.medical_specialty
Ejection fraction business.industry medicine.medical_treatment Atrial fibrillation Retrospective cohort study Perioperative 030204 cardiovascular system & hematology medicine.disease Implantable cardioverter-defibrillator Sudden cardiac death 03 medical and health sciences 0302 clinical medicine Internal medicine Heart failure medicine Cardiology 030212 general & internal medicine Complication business |
Zdroj: | World Journal of Cardiovascular Diseases. :79-90 |
ISSN: | 2164-5337 2164-5329 |
DOI: | 10.4236/wjcd.2017.73009 |
Popis: | Implantable cardioverter-defibrillator (ICD) in heart failure with reduced ejection fraction (EF) patients reduces risk for sudden cardiac death (SCD). Previous data suggest that the benefit of ICD therapy in real life may be lower than expected from the results of controlled studies and only about one-third of ICD patients receive appropriate therapies. Nevertheless, all ICD patients are at risk of perioperative complications and inappropriate shocks. We retrospectively studied 613 patients undergoing ICD for primary prevention in 2002-2015; we excluded inherited arrhythmogenic syndromes. Patients underwent 12-leads ECG, echocardiography, laboratory tests and quality of life questionnaire. We evaluated comorbidities, appropriate therapies, complications and all-cause mortality. Consecutive patients (age 67 ± 10 years, 81% males, 59% ischaemic aetiology) were followed for 51 ± 31 months. 198 patients (32%) received appropriate ICD therapy, 93 (15%) had inappropriate shocks, 53 (8%) had at least one complication (electrode dysfunction, infection and pocket related) and 191 (33%) died. Multivariate analysis showed atrial fibrillation (OR = 1.8, CI = 1.27 - 2.53; p |
Databáze: | OpenAIRE |
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