Implantable Cardioverter‐Defibrillator Therapy in Patients With Ventricular Fibrillation out of Hospital Cardiac Arrest Secondary to Acute Coronary Syndrome

Madhavan, Malini; Friedman, Paul A.; Lennon, Ryan J.; Prasad, Abhiram; White, Roger D.; Sriram, Chenni S.; Gulati, Rajiv; Gersh, Bernard J.

doi:10.1161/jaha.114.001255

Cited by 21 publications

(9 citation statements)

References 30 publications

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“…A pesar de contar con una muestra poblacional mayor, su resultado respecto a la sobrevida demostró resultados similares con nuestra experiencia. Con respecto al ritmo de paro, ellos describieron que los pacientes que presentan con Fibrilación Ventricular tienen un riesgo menor de muerte que los que se presentan con Taquicardia Ventricular, Asistolia o Actividad Eléctrica sin Pulso, haciendo referencia a descripciones en otros estudios 12,13 . En nuestro estudio solo un paciente falleció por un evento arrítmico, con lo cual creemos que la utilización del desfibrilador si impactó en la supervivencia de nuestra población.…”

Section: Resultsunclassified

Supervivencia a 30 días y 1 año de pacientes con muerte súbita con posterior colocación de dispositivo cardíaco implantable en un hospital de alta complejidad

et al. 2020

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Patients with sudden cardiac death receiving an implantable cardiac device: survival at 30 days and one year Background: The use of implantable cardiac devices in patients with sudden cardiac arrest has contributed to their survival. Aim: To determine the survival rate at 30 days and one year after hospital discharge of patients who had a cardiac arrest with subsequent placement of an implantable cardiac device. Material and Methods: Twenty-three patients older than 18 years who presented sudden extra-institutional or intra-institutional death with subsequent implantation of an implantable cardiac device and whose survival was recorded at 30 days and one year, were included. A univariate analysis was performed. Results: Eighteen patients had an extra institutional cardiac arrest. All patients were discharged alive. We could not ascertain the health status of one patient at follow-up. Twenty-one patients had a Cerebral Performance Category (CPC) of 1 at discharge. One patient died of a stroke within 30 days and one patient died due to an arrhythmic electrical storm one year later. Twenty patients survived at least one year after hospital discharge. Conclusions: Survival at 30 days and one year, was high in patients with sudden death or cardiac arrest who required intracardiac devices.

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Section: Resultsunclassified

Supervivencia a 30 días y 1 año de pacientes con muerte súbita con posterior colocación de dispositivo cardíaco implantable en un hospital de alta complejidad

et al. 2020

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“…ICD benefit has been demonstrated in primary SCD prevention trials in patients with acute myocardial infarction and depressed ejection fraction < 35% [32] or when LV ejection fraction < 40% was ac-companied by non-sustained ventricular tachycardia and an inducible sustained ventricular tachycardia at the electrophysiologic study [26]. ICD implantation has been associated with improved survival in patients with ejection fraction > 35% who suffered SCD from an ischemic event [33]. However, since acute myocardial ischemia may be a reversible cause of cardiac arrest, SCD treated patients with obstructive CAD or ST elevations are currently not considered for secondary prevention and do not undergo ICD implantation [19].…”

Section: Discussionmentioning

confidence: 99%

Ventricular Arrhythmia-Free Survival Following Therapeutic Hypothermia in Patients with Sudden Cardiac Death Due to Ventricular Tachycardia or Fibrillation

Saour¹,

Ji²,

Philbin³

et al. 2017

IJCM

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Background: The potential benefits of implantable cardioverter-defibrillator (ICD) therapy in patients with sudden cardiac death (SCD) treated with therapeutic hypothermia (TH) have not been well studied. Methods: Incidence of recurrent non-sustained ventricular arrhythmia, ICD therapy, and death were ascertained in 64 consecutive survivors of SCD due to ventricular fibrillation or tachycardia, who were treated with TH. Follow-up was 31.5 +/− 3.3 months in 41 ICD recipients and 36.3 +/− 3.9 months in 23 patients who did not receive an ICD due to the presence of a reversible cause of cardiac arrest, an acute myocardial infarction in 87%. Results: Combined incidence of ventricular arrhythmia, ICD therapy, or death in patients who underwent ICD placement (21.9%) were similar to overall mortality in the patients who did not receive an ICD (21.7%, p = 0.752). ICD placement was associated with a significant mortality benefit; 95.1% survival in ICD recipients vs. 78.3% in the no-ICD group (p = 0.038). Electrocardiographic findings of ST segment elevation on admission were associated with increased event rate in ICD recipients (p = 0.039) and increased mortality in SCD patients who did not receive an ICD (p < 0.001). Other studied variables had no significant effect on the investigated outcomes. Conclusions: SCD survivors treated with TH are at increased risk for recurrent arrhythmic events and derive significant mortality benefit from ICD implantation. Increased mortality in revascularized SCD patients with acute coronary syndrome, thought to have a reversible cause of cardiac arrest, calls for prospective trials investigating utility of ICD in this vulnerable patient population.

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“…A previous study 15 showed that the rate of ICD therapy in patients with ischemic heart disease was 35 at 3 years, and patients with EF ≤ 35 at the time of discharge were at higher risk of recurrent ventricular arrhythmia. Furthermore, patients with EF 35 were declared at risk from ICD therapy in the rst eight months after OHCA.…”

Section: Appropriate Icd Therapy For Vf-ohca Due To a Reversible Causementioning

confidence: 95%

“…The recommendations around ICD implantation for VF-OHCA due to ischemic heart disease remain controversial. Madhavan et al 15 reported that ICD implantation with VF-OHCA due to ischemic heart disease did not have a statistically significant association with reduced allcause mortality after adjusting for potential confounders, but showed a trend towards signi cance. In contrast, Ladejobi et al 8 reported an association between ICD therapy and lower allcause mortality except for VF-OHCA due to ischemic heart disease.…”

Section: Icd Implantation For MI and Ischemic Heart Diseasementioning

confidence: 99%

Effect of Implantable Cardioverter-defibrillator Therapy for Ventricular Fibrillation Patients with Out-of-hospital Cardiac Arrest

Gokan

Kawamura

Arai

et al. 2020

Showa Univ J Med Sci

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Survivors of ventricular fibrillation out-of-hospital cardiac arrest VF-OHCA due to potentially reversible causes such as acute coronary syndrome ACS , vasospastic angina and electrolyte abnormalities are considered low risk for recurrent arrhythmia. Accordingly, implantable cardioverter-de brillator therapy is not routinely recommended in such patients. We investigated the risk of mortality and the value of ICD therapy for VF-OHCA. Among 2,248 cardiopulmonary arrest patients presenting at our hospital, we retrospectively investigated 110 patients with VF-OHCA who were admitted for treatment. We divided the patients based on ICD n 71 or No-ICD status n 39 , and on reversible cause n 70 or irreversible cause n 40. The groups were compared for baseline characteristics, mortality and ICD therapies. Patients with a reversible cause had a signi cantly lower rate of ICD implantation than those with an irreversible cause P 0.03. Males in the ICD group presented more frequently than those in the No-ICD group, and cardiac mortality in patients with acute coronary syndrome was signicantly lower with ICD therapy than without ICD P 0.04. The rate of appropriate ICD therapies with a reversible cause was 28 , and the rst ICD therapy was highest within 1 year post-implantation. Patients with VF-OHCA due to a reversible cause remain at high risk of recurrent ventricular arrhythmias, suggesting that ICD implantation is a reasonable approach in such cases.

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Implantable Cardioverter‐Defibrillator Therapy in Patients With Ventricular Fibrillation out of Hospital Cardiac Arrest Secondary to Acute Coronary Syndrome

Cited by 21 publications

References 30 publications

Supervivencia a 30 días y 1 año de pacientes con muerte súbita con posterior colocación de dispositivo cardíaco implantable en un hospital de alta complejidad

Supervivencia a 30 días y 1 año de pacientes con muerte súbita con posterior colocación de dispositivo cardíaco implantable en un hospital de alta complejidad

Ventricular Arrhythmia-Free Survival Following Therapeutic Hypothermia in Patients with Sudden Cardiac Death Due to Ventricular Tachycardia or Fibrillation

Effect of Implantable Cardioverter-defibrillator Therapy for Ventricular Fibrillation Patients with Out-of-hospital Cardiac Arrest

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