Driving Restrictions and Early Arrhythmias in Patients Receiving a Primary-Prevention Implantable Cardioverter-Defibrillator (DREAM-ICD) Study
| Autor: | François Philippon, Amit Sodhi, Christopher C. Cheung, Santabhanu Chakrabarti, Jason G. Andrade, Jean-François Sarrazin, Franck Molin, Zachary Laksman, Isabelle Nault, Benoit Plourde, Karine Roy, John A. Staples, Gilles O'Hara, Christian Steinberg, Andrew D. Krahn, Jean Champagne, Darryl Wan, Louis Blier, Marc W. Deyell, John A. Yeung-Lai-Wah, Sebastian Claros, Nathaniel M. Hawkins, Matthew T. Bennett |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Automobile Driving Canada medicine.medical_specialty Time Factors medicine.medical_treatment Electric Countershock MEDLINE 030204 cardiovascular system & hematology Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors Primary prevention medicine Humans In patient 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over Medical treatment business.industry Incidence Incidence (epidemiology) Arrhythmias Cardiac Retrospective cohort study Middle Aged Implantable cardioverter-defibrillator Defibrillators Implantable Primary Prevention Increased risk Emergency medicine Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Canadian Journal of Cardiology. 36:1269-1277 |
| ISSN: | 0828-282X |
| DOI: | 10.1016/j.cjca.2020.05.029 |
| Popis: | Current guidelines recommend 4 weeks of private driving restriction after implantation of a primary-prevention implantable cardioverter-defibrillator (ICD). These driving restrictions result in significant inconvenience and social implications. Advances in medical treatment and ICD programming have lowered the overall rate of device therapies. The objective of this study was to assess the incidence of ICD therapies at 30, 60, and 180 days after implantation.Driving Restrictions and Early Arrhythmias in Patients Receiving a Primary-Prevention Implantable Cardioverter-Defibrillator (DREAM-ICD) was a retrospective cohort study conducted at 2 Canadian university centres enrolling patients with new implantation of a primary-prevention ICD. Device programming was standardised according to current guidelines. A total of 803 patients were enrolled.The cumulative rates of appropriate ICD therapies at 30, 60, and 180 days were 0.12%, 0.50%, and 0.75%, respectively. There was no syncope during the first 6 months. The median duration to the first appropriate ICD therapy was 208 (range 23-1109) days after implantation. The rate of inappropriate ICD therapies at 30 days was only 0.2%. Overall,13.6% of all appropriate ICD therapies occurred within the first 6 months after implantation.The rate of appropriate ICD therapies within the first 30 days after device insertion is extremely low in contemporary primary prevention cohorts with guideline-concordant device programming. There was no increased risk for ventricular arrhythmia early after ICD insertion. The results of DREAM-ICD suggest the need for a revision of the existing driving restrictions for primary-prevention ICD recipients. |
| Databáze: | OpenAIRE |
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