Primary prevention with the ICD in clinical practice: not as straightforward as the guidelines suggest?

Bracke, Frank; Dekker, L.R.C.; Voort, Pepijn H. van der; Meijer, Albert

doi:10.1007/bf03086228

Cited by 8 publications

(7 citation statements)

References 43 publications

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“…The question is in which patients and in how many of them we actually prevent a sudden cardiac death. Critical articles about the sense and non-sense of ICD implantation for primary prophylaxis in certain patient populations have given rise to some doubts making it more difficult to implement and interpret guidelines accurately [16, 17]. This results in a higher number of non-evidence-based ICD implantations on one hand and a substantial number of patients eligible for ICD implantation, which are not recognised on the other.…”

Section: Introductionmentioning

confidence: 99%

Implementation of guidelines for implantable cardioverter-defibrillator therapy in clinical practice: Which patients do benefit?

et al. 2013

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PurposeBased on multiple large clinical trials conducted over the last decades guidelines for implantable cardioverter-defibrillator (ICD) implantations have been evolving. The increase in primary prophylactic ICD implantations challenges us to be critical towards the indications in certain patient populations.MethodsWe retrospectively collected patient characteristics and rates of appropriate and inappropriate ICD therapy, appropriate and inappropriate ICD shock and mortality of all patients who received an ICD in the University Medical Center Utrecht (UMCU) over the years 2006–2011.ResultsA total of 1075 patients were included in this analysis (74 % male, mean age 61 ± 13 years, left ventricular ejection fraction 30 ± 13 %); 61 % had a primary indication and 58 % had ischaemic heart disease. During a mean follow-up period of 31 ± 17 months, 227 of the patients (21 %) received appropriate ICD therapy (149 (14 %) patients received an appropriate ICD shock). Females, patients with a primary prophylactic indication and patients with non-ischaemic heart disease experienced significantly less ICD therapy. Only a few patients (54, 5 %) received inappropriate ICD therapy; 33 (3 %) patients received an inappropriate ICD shock. Fifty-five patients died within one year after ICD implantation and were therefore, in retrospect, not eligible for ICD implantation.ConclusionOur study confirms the benefit of ICD implantation in clinical practice. Nevertheless, certain patients experience less benefit than others. A more patient-tailored risk stratification based on electrophysiological parameters would be lucrative to improve clinical benefit and cost-effectiveness.

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Section: Introductionmentioning

confidence: 99%

Implementation of guidelines for implantable cardioverter-defibrillator therapy in clinical practice: Which patients do benefit?

et al. 2013

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“…However, the majority of patients who receive an ICD never need it, and many more who do not qualify for an ICD go on to experience SCD. 43 There is therefore a need for improved tools to more precisely identify patients with ischemic cardiomyopathy who are at risk for SCD. One approach has been to study the underlying electrophysiological properties of the myocardium in heart failure.…”

Section: Musunuru Et Al Expressed Genome In Cardiovascular Diseases Amentioning

confidence: 99%

The Expressed Genome in Cardiovascular Diseases and Stroke: Refinement, Diagnosis, and Prediction: A Scientific Statement From the American Heart Association

Musunuru¹,

Ingelsson²,

Fornage³

et al. 2017

Circ Cardiovasc Genet

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Abstract-There have been major advances in our knowledge of the contribution of DNA sequence variations to cardiovascular disease and stroke. However, the inner workings of the body reflect the complex interplay of factors beyond the DNA sequence, including epigenetic modifications, RNA transcripts, proteins, and metabolites, which together can be considered the "expressed genome." The emergence of high-throughput technologies, including epigenomics, transcriptomics, proteomics, and metabolomics, is now making it possible to address the contributions of the expressed genome to cardiovascular disorders. This statement describes how the expressed genome can currently and, in the future, potentially be used to diagnose diseases and to predict who will develop diseases such as coronary artery disease, stroke, heart failure, and arrhythmias. (Circ Cardiovasc Genet. 2017;10:e000037. DOI: 10.1161/HCG.0000000000000037.)Key Words: AHA Scientific Statements ◼ cardiovascular diseases ◼ DNA ◼ epigenomics ◼ genome ◼ metabolomics ◼ proteomics ◼ strokeThe American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on March 13, 2017, and the American Heart Association Executive Committee on April 17, 2017. A copy of the document is available at http://professional.heart.org/statements by using either "Search for Guidelines & Statements" or the "Browse by Topic" area. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@ wolterskluwer.com.The American Heart Association requests that this document be cited as follows: Expert peer review of AHA Scientific Statements is conducted by the AHA Office of Science Operations. For more on AHA statements and guidelines development, visit http://professional.heart.org/statements. Select the "Guidelines & Statements" drop-down menu, then click "Publication Development."Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.heart.org/HEARTORG/General/CopyrightPermission-Guidelines_UCM_300404_Article.jsp. A link to the "Copyright Permissions Request Form" appears on the right side of the page. I n no small part as a result of the completion of the Human Genome Project, considerable effort has been invested over the past few decades in understanding the contribution of genetics to the risk of cardiovascular diseases and stroke. Genomewide association studies, candidate gene sequencing studies, a...

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“…A more precise ICD selection prevents inappropriate shocks, complications as infection and recalls for technical failures. In this journal, Bracke et al [5] and Wilde and Simmers [6] recently pointed to the potential overuse of ICD for primary prevention and plead for adaptation of current guidelines.…”

Section: Pacemaker Trouble Shootingmentioning

confidence: 99%

Fresh Arrhythmia News: Suitable for Daily Use?

Hemel

2010

Neth Heart J

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Primary prevention with the ICD in clinical practice: not as straightforward as the guidelines suggest?

Cited by 8 publications

References 43 publications

Implementation of guidelines for implantable cardioverter-defibrillator therapy in clinical practice: Which patients do benefit?

Implementation of guidelines for implantable cardioverter-defibrillator therapy in clinical practice: Which patients do benefit?

The Expressed Genome in Cardiovascular Diseases and Stroke: Refinement, Diagnosis, and Prediction: A Scientific Statement From the American Heart Association

Fresh Arrhythmia News: Suitable for Daily Use?

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