Prognostic Importance of Defibrillator Shocks in Patients with Heart Failure

Poole, Jeanne E.; Johnson, George; Hellkamp, Anne S.; Anderson, Jill; Callans, David J.; Raitt, Merritt H.; Reddy, Ramakota K.; Marchlinski, Francis E.; Yee, Raymond; Guarnieri, Thomas; Talajic, Mario; Wilber, David J.; Fishbein, Daniel P.; Packer, Douglas L.; Mark, Daniel B.; Lee, Kerry L.; Bardy, Gust H.

doi:10.1056/nejmoa071098

Cited by 1,289 publications

(889 citation statements)

References 19 publications

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“…The initial generations of ICDs did not record and save electrograms (EGMs), leading to a reduced appreciation for the frequency and impact of inappropriate shocks. With the advent and then dominance of primary prevention indications, avoidable shocks assumed a relatively larger proportion of total therapy [78][79][80][81][82][83]. Gradually, publications have increased awareness of the frequency and the diverse range of adverse outcomes associated with avoidable ICD therapy, and have demonstrated that avoidable ICD shocks can be reduced by evidence-based programming of the detection rate, detection duration, antitachycardia pacing (ATP), algorithms that discriminate supraventricular tachycardia (SVT) from VT, and specific programming to minimize the sensing of noise [81][82][83][84][85][86][87][88][89][90][91][92].…”

Section: Tachycardia Detection Programmingmentioning

confidence: 99%

“…Although therapies delivered by the ICD can abort SCD, appropriate and inappropriate ICD shocks have been associated with a considerable increase in the risk of mortality [82,83,[155][156][157][158]. In the Sudden Cardiac Death in Heart Failure Trial (SCDHeFT), the risk of mortality was 5-fold higher in patients who received appropriate ICD shocks and 2-fold higher in patients who received inappropriate shocks [83].…”

Section: Tachycardia Therapy Programmingmentioning

confidence: 99%

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2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

et al. 2016

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Section: Tachycardia Detection Programmingmentioning

confidence: 99%

Section: Tachycardia Therapy Programmingmentioning

confidence: 99%

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

et al. 2016

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“…It is also possible that the PHIV with an ICD were sicker for other reasons, such as concomitant infections/lower CD4 cell count, and therefore more likely to have an ICD discharge. There are no comparative prior data on ICD discharge among PHIV; however, we can compare our findings from the uninfected control group to ICD discharge rates among people without known HIV 43, 44, 45. We noted an ICD discharge rate of 23% among uninfected controls over 19 months of follow‐up.…”

Section: Discussionmentioning

confidence: 61%

Incidence, Predictors, and Outcomes of Implantable Cardioverter‐Defibrillator Discharge Among People Living With HIV

Alvi

Neilan

Tariq

et al. 2018

JAHA

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BackgroundPeople living with HIV (PHIV) are at an increased risk for sudden cardiac death, and implantable cardioverter‐defibrillators (ICDs) prevent SCD. There are no data on the incidence, predictors, and effects of ICD therapies among PHIV.Methods and ResultsWe compared ICD discharge rates between 59 PHIV and 267 uninfected controls. For PHIV, we tested the association of traditional cardiovascular risk factors and HIV‐specific parameters with an ICD discharge and then tested whether an ICD discharge among PHIV was associated with cardiovascular mortality or an admission for heart failure. The indication for ICD insertion was similar among groups. Compared with controls, PHIV with an ICD were more likely to have coronary artery disease and to use cocaine. In follow‐up, PHIV had a higher ICD discharge rate (39% versus 20%; P=0.001; median follow‐up period, 19 months). Among PHIV, cocaine use, coronary artery disease, QRS duration, and higher New York Heart Association class were associated with an ICD discharge. An ICD discharge had a prognostic effect, with a subsequent 1.7‐fold increase in heart failure admission and a 2‐fold increase in cardiovascular mortality, an effect consistent across racial/ethnic and sex categories.Conclusions ICD discharge rates are higher among PHIV compared with uninfected controls. Among PHIV, cocaine use and New York Heart Association class are associated with increased ICD discharge, and an ICD discharge is associated with a subsequent increase in admission for heart failure and cardiovascular mortality.

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“…Although ICD shocks could terminate those arrhythmias immediately, they would result in both physical and psychological damages and even increase the mortality and hospitalization as proved in some previous studies 2, 3, 4…”

Section: Introductionmentioning

confidence: 90%

What factors lead to the acceleration of ventricular tachycardia during antitachycardia pacing?—Results from over 1000 episodes

Fang

Yang

et al. 2017

Journal of Arrhythmia

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IntroductionVentricular tachycardia (VT) acceleration due to antitachycardia pacing (ATP) therapy could be often observed in patients with implantable cardioverter defibrillator (ICD), which usually results in additional shock. However, few studies focused on the risk factors for VT acceleration caused by ATP therapy. The purpose of this study was to investigate risk factors for VT acceleration due to ATP delivery.MethodsWe retrospectively reviewed 1056 ATP episodes in 33 patients with structural heart diseases, of whom clinical characteristics and episodes details were evaluated.ResultsAt individual patient level, number of VT morphologies recorded in electrograms during follow‐up was a risk factor with cutoff point of 1 (AUC 0.79, sensitivity 72.7%, specificity 77.3%, P < .001) to predict ATP acceleration (OR 3.50, P = .008). From episode‐based analysis, VT cycle length (VTCL) and mean variation in VTCL were risk factors to predict ATP acceleration (OR 0.98, P < 0.001 vs OR 1.06, P < .001, respectively), with cutoff points of 347 ms (AUC 0.67, sensitivity 82.5%, specificity 47.6%, P < .001) and 7.3 ms (AUC 0.66, sensitivity 77.5%, specificity 56.7%, P < .001), respectively. In addition, VTs with cycle length less than 347 ms were more likely to be accelerated by burst stimulation with more pulse numbers (OR 3.31, P < .001).ConclusionsNumber of VT morphologies, VTCL, and mean variation in VTCL are risk factors predicting ATP acceleration. Burst stimulation with less pulse numbers should be performed in VTs with cycle length less than 347 ms.

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Prognostic Importance of Defibrillator Shocks in Patients with Heart Failure

Cited by 1,289 publications

References 19 publications

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

Incidence, Predictors, and Outcomes of Implantable Cardioverter‐Defibrillator Discharge Among People Living With HIV

What factors lead to the acceleration of ventricular tachycardia during antitachycardia pacing?—Results from over 1000 episodes

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