Predictors of Appropriate Implantable Cardioverter Defibrillator (ICD) Therapy in Primary Prevention Patients with Ischemic and Nonischemic Cardiomyopathy

Verma, Atul; Sarak, Bradley; Kaplan, Alon; Oosthuizen, Richard; Beardsall, Marianne; Wulffhart, Zaev; Higenbottam, Janet; Khaykin, Yaariv

doi:10.1111/j.1540-8159.2009.02566.x

Cited by 50 publications

(39 citation statements)

References 38 publications

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“…Ninety-four episodes of VF were observed in four Chagas and 7 episodes of VF in two non-Chagas cardiomyopathy patients (p = 0.03). Median time to first event was 78 The frequency of shock occurrence observed in our Chagas cardiomyopathy cohort in this study was similar to that reported in patients with non-Chagas cardiomyopathy [3]. The lower mortality rate observed in our study in comparison to studies of secondary prevention of SCD [4] in Chagas disease patients may partially be explained by the lower frequency of shock occurrence.…”

supporting

confidence: 88%

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Implantable Cardioverter-Defibrillator therapy for primary prevention of sudden cardiac death in patients with severe Chagas cardiomyopathy

Cardinalli-Neto

Nakazone

Grassi

et al. 2011

International Journal of Cardiology

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supporting

confidence: 88%

“…Median of episodes per patient was 6.5 (3,38). Ninety-four episodes of VF were observed in four Chagas and 7 episodes of VF in two non-Chagas cardiomyopathy patients (p = 0.03).…”

mentioning

confidence: 99%

Implantable Cardioverter-Defibrillator therapy for primary prevention of sudden cardiac death in patients with severe Chagas cardiomyopathy

Cardinalli-Neto

Nakazone

Grassi

et al. 2011

International Journal of Cardiology

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“…Our finding that diabetes mellitus is associated with an increased risk of appropriate therapy supports 2 previous studies, 7,11 but compared with the predictors of appropriate therapy previously found in the larger trials such as Multicenter Automatic Defibrillator Implantation Trial II (MADIT-II), Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT), Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION), Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction (REVERSE), Cardiac Resynchronization-Heart Failure (CARE-HF), and others, this is a novel finding. [12][13][14][15][16][17][18][19][20][21] Our explanation for the risk association of diabetes mellitus with appropriate ICD therapy includes a vulnerable myocardium resulting from fibrosis, ischemia, and scar tissue; reduced autonomic function; and reduced coronary circulation in diabetics, [22][23][24][25] rendering the myocardium more prone to produce ventricular arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

Influence of Diabetes Mellitus on Inappropriate and Appropriate Implantable Cardioverter-Defibrillator Therapy and Mortality in the Multicenter Automatic Defibrillator Implantation Trial–Reduce Inappropriate Therapy (MADIT-RIT) Trial

et al. 2013

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T he Multicenter Automatic Defibrillator Implantation TrialReduce Inappropriate Therapy (MADIT-RIT) showed that innovative implantable cardioverter-defibrillator (ICD) programming was associated with a reduction in inappropriate therapy and mortality.1 The MADIT-RIT trial randomized patients with a primary prophylactic ICD indication to 3 different types of ICD programming: conventional programming with a ventricular tachycardia (VT) zone of 170 to 199 bpm, high-rate cutoff with a VT zone ≥200 bpm, or 60-seconddelayed therapy during a VT zone of 170 to 199 bpm. Clinical Perspective on p 701Background-The relationship between diabetes mellitus and risk of inappropriate or appropriate therapy in patients receiving an implantable cardioverter-defibrillator (ICD) and resynchronization therapy has not been investigated thoroughly. The effect of innovative ICD programming on therapy delivery in these patients is unknown. Methods and Results-The Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT) randomized patients with a primary prophylactic ICD indication to 3 different types of ICD programming: conventional programming with a ventricular tachycardia zone of 170 to 199 bpm (arm A), high-rate cutoff with a ventricular tachycardia zone ≥200 bpm (arm B), or 60-second-delayed therapy (arm C). The end points of inappropriate therapy, appropriate therapy, and death were assessed among 485 patients with and 998 without diabetes mellitus. Innovative ICD programming reduced the risk of inappropriate therapy regardless of diabetes mellitus, although a trend toward a more pronounced effect of high-rate cutoff programming was seen in patients without diabetes mellitus (P for interaction=0.06). Diabetes mellitus was associated with a decreased risk of inappropriate therapy (hazard ratio, 0.54; 95% confidence interval, 0.36-0.80; P=0.002) and increased risk of appropriate therapy (hazard ratio,1.58; 95% confidence interval, 1.17-2.14; P=0.003). In diabetic patients, there was significantly increased risk of death in those who had inappropriate therapy (hazard ratio, 4.17; 95% confidence interval, 1.52-11.40; P=0.005) and appropriate therapy (hazard ratio, 2.49; 95% confidence interval, 1.06-5.87; P=0.037) compared with those who did not. Conclusions-Innovative high-rate cutoff or delayed ICD programming was associated with a reduction in inappropriate therapy in patients with and without diabetes mellitus. Diabetes mellitus was associated with lower risk of inappropriate therapy but higher risk of appropriate therapy. Ruwald et al Diabetes Mellitus and ICD Programming and Therapy 695Diabetes mellitus is a growing burden to the healthcare system. It affects 25.8 million of the US population (8.3%) and is a major cause of heart disease and stroke. In ICD patients, diabetes mellitus is associated with an increased risk of hospitalization for heart failure, sudden cardiac death, and all-cause mortality 2-6 ; however, the association between diabetes mellitus and inappropriate and appropria...

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“…The incidence of appropriate therapy in their study was about 19%. 15 The frequency of NSVAs in the present study was about 54.8% which may to some degree justify the relatively high incidence of SVAs.…”

mentioning

confidence: 72%

Role of QT dispersion and Tp-e interval after biventricular pacing in the incidence of sustained ventricular arrhythmias in patients with implanted cardiac resynchronization therapy device

Akbarzadeh¹,

Ataeye²,

Kazemi³

et al. 2017

J Anal Res Clin Med

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CardiacResynchronization Therapy, Heart Failure, Cardiac ArrhythmiasQT dispersion (QTd) and Tp-e interval show controversial results in incidence of sustained ventricular arrhythmias (SVA) in patients with heart failure (HF). In patients with implanted cardiac resynchronization therapy (CRT) device, there is a unique opportunity to record SVAs. The aim of this study was to evaluate the effects of QTd and Tp-e interval on the incidence of SVAs after simultaneous biventricular (Biv) pacing.In the present study, 31 consecutive patients with advanced HF and implanted CRT device were evaluated one year for possible SVAs, corrected QT (QTc), QTd, and Tp-e interval. Patients were divided into two groups; with (group 1) and without (group 2) SVAs.Among the studied patients, 5 (16%) experienced SVAs. The intrinsic and Biv pacing QTd were 70.74 ± 18.00 and 89.26 ± 28.00 msec, and 95.09 ± 44 and 88.09 ± 33 msec in group 1 and group 2, respectively (P = 0.18 and P = 0.16, respectively). Tp-e was not different between the two groups. In group 1, QTc increased from 438.83 ± 64 msec to 488.24 ± 48 msec (P = 0.13), and in group 2, it decreased from 499.70 ± 65.00 msec to 480.00 ± 31.00 msec after simultaneous Biv pacing (P = 0.13).QTd, Tp-e, and QTc did not differ significantly after Biv pacing to show any positive effect on the incidence of SVAs in part due to the severity of changes which already occur in patients with advanced HF. QTc, QTd, and Tp-e showed little changes after Biv pacing and probably do not have a significant role in the incidence of SVAs.Citation: Akbarzadeh F, Ataeyeh S, Kazemi B, Akbarzadeh A, Safaei N. Role of QT dispersion and Tp-e interval after biventricular pacing in the incidence of sustained ventricular arrhythmias in patients with implanted cardiac resynchronization therapy device.

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Predictors of Appropriate Implantable Cardioverter Defibrillator (ICD) Therapy in Primary Prevention Patients with Ischemic and Nonischemic Cardiomyopathy

Abstract: ICD-delivered therapy occurred in 19% of primary prevention patients with both ischemic and dilated cardiomyopathy and was predicted by NSVT and a lack of beta-blocker use.

Cited by 50 publications

References 38 publications

Implantable Cardioverter-Defibrillator therapy for primary prevention of sudden cardiac death in patients with severe Chagas cardiomyopathy

Implantable Cardioverter-Defibrillator therapy for primary prevention of sudden cardiac death in patients with severe Chagas cardiomyopathy

Influence of Diabetes Mellitus on Inappropriate and Appropriate Implantable Cardioverter-Defibrillator Therapy and Mortality in the Multicenter Automatic Defibrillator Implantation Trial–Reduce Inappropriate Therapy (MADIT-RIT) Trial

Role of QT dispersion and Tp-e interval after biventricular pacing in the incidence of sustained ventricular arrhythmias in patients with implanted cardiac resynchronization therapy device

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