Comparison of Frequency of Ventricular Tachyarrhythmia in Men-Versus-Women in Patients with Implantable Cardioverter-Defibrillator for Primary Prevention

Ojo, Amole; Younis, Arwa; Saxena, Shireen; Kutyifa, Valentina; Chen, Anita Y.; McNitt, Scott; Polonsky, Bronislava; Aktaş, Mehmet K.; Huang, David T.; Rosero, Spencer; Vidula, Himabindu; Diamond, Alexander; Sampath, Ramya; Klein, Helmut U.; Steiner, Hillel; Zaręba, Wojciech; Goldenberg, Ilan

doi:10.1016/j.amjcard.2022.04.027

Cited by 2 publications

(1 citation statement)

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“…This is not surprising as a prior study done by our group showed that in a cohort consisted of 4506 patients with an ICD or cardiac resynchronization therapy-defibrillator (CRT-D) who were enrolled in the four landmark MADIT studies, at 3.5 years of followup, cumulative incidence of ventricular tachyarrhythmia (VTA) was significantly lower among women than men (17% vs. 26%, respectively; p < .001 for entire follow-up). 30 Different mechanisms have been proposed to explain this sex-specific difference in the incidence of VTA. Women tend to have nonischemic cardiomyopathy and hence, may have less fibrosis and scarring.…”

Section: Potential Explanation Of Findingsmentioning

confidence: 99%

Association of device detected atrial and ventricular tachyarrhythmia with adverse events in patients with an implantable cardioverter‐defibrillator

Abbas,

Younis,

Goldenberg

et al. 2024

Cardiovasc electrophysiol

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IntroductionHeart failure patients with a history of atrial fibrillation (AF) and ventricular tachycardia/ventricular fibrillation (VT/VF) are known to have worse outcomes. However, there are limited data on the temporal relationship between development of these arrhythmias and the risk of subsequent congestive heart failure (CHF) exacerbation and death.MethodsThe study cohort comprised 5511 patients implanted with an implantable cardioverter‐defibrillator (ICD) in landmark clinical trials (MADIT‐II, MADIT‐RISK, MADIT‐CRT, MADIT‐RIT, and RAID) who were in sinus rhythm at enrollment. Multivariate cox analysis was performed to evaluate the time‐dependent association between development of in‐trial device detected AF and VT/VF with subsequent CHF exacerbation and death.ResultsMultivariate analysis showed that AF occurrence and VT/VF occurrence were both associated with a similar magnitude of risk for subsequent CHF exacerbation (HR = 1.73 and 1.87 respectively, p < .001 for both). In contrast, only in‐trial VT/VF was associated with a significant > two‐fold increase in the risk of subsequent mortality (HR = 2.13, p < .001) whereas AF occurrence was not associated with a significant mortality increase after adjustment for in‐trial VT/VF (HR = 1.36, p = .096).ConclusionOur findings from a large cohort of ICD recipients enrolled in landmark clinical trials show that device detected AF and VT/VF can be used to identify patients with increased risk for CHF exacerbation and mortality. These findings suggest a need for early intervention in CHF patients who develop device‐detected atrial and ventricular tachyarrhythmias.

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Section: Potential Explanation Of Findingsmentioning

confidence: 99%