| Autor: |
Satoshi Kawada, MD, PhD, Praloy Chakraborty, DM, FACC, Jared Nanthakumar, Lisa Albertini, MD, Erwin N. Oechslin, MD, Susan Lucy Roche, MD, Candice Silversides, MD, Rachel M. Wald, MD, Eugene Downar, MD, Louise Harris, MD, Lorna Swan, MD, Rafael Alonso-Gonzalez, MD, Sara Thorne, MD, Kumaraswamy Nanthakumar, MD, Blandine Mondésert, MD, Paul Khairy, MD, PhD, Krishnakumar Nair, DM |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
|
| Zdroj: |
International Journal of Cardiology Congenital Heart Disease, Vol 8, Iss , Pp 100355- (2022) |
| Druh dokumentu: |
article |
| ISSN: |
2666-6685 |
| DOI: |
10.1016/j.ijcchd.2022.100355 |
| Popis: |
Aims: Sudden cardiac death (SCD) is a major cause of mortality in adults with congenital heart disease (ACHD). The role of implantable cardioverter-defibrillator (ICDs) in preventing SCD has been established, however, robust, clinical evidence-based guidelines are lacking in ACHD. The aim of this study was to evaluate the ICD guidelines in ACHD patients. Methods and Results: A total of 131 ACHD patients (male: n = 96 (73.3%), mean age: 42.8 ± 14.7 years, mean follow-up: 40.9 ± 28.3 months) undergoing ICDs implantation between 2010 and 2017 were reviewed. Sixty-nine patients (52.6%) received ICDs for a primary prevention indication. 122 (93.3%) patients had congenital heart disease of moderate to severe complexity. CRT-D (implantable cardiac resynchronization defibrillator) was implanted in 55 (42.0%) patients. During follow-up, 23 patients (17.6%) received appropriate ICD therapy. According to the current guideline (PACES/HRS 2014), 84 (64.1%), 8 (6.1%), and 39 (29.8%) could be classified as Class Ⅰ, Class Ⅱa, and Class Ⅱb indication, respectively. Compared to patients with Class Ⅱa and IIb indication, those with Class Ⅰ indication received more appropriate therapy (P = 0.030). Multivariate analysis showed that age (per 10-years decrease; P = 0.015, HR 1.254 CI; 1.045–1.505) and creatinine (per 100-μmol/L increase; P = 0.019, HR 1.555 CI; 1.076–2.247) were associated with appropriate therapy. Conclusion: Implantation of ICDs for preventing SCD based on current guidelines is reasonable. For patients with a borderline indication, younger age and renal dysfunction may aid in the selection of ICDs candidates. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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