Ventricular Arrhythmias in Patients With Implanted Defibrillators

Stevenson, William G.; John, Roy M.

doi:10.1161/circulationaha.111.064816

Cited by 16 publications

(8 citation statements)

References 45 publications

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“…For example, amiodarone is a common pharmacological option in patients with significant structural heart disease, but is known to have non-cardiac toxicities and is associated with increased mortality in patients with class III heart failure who do not have ICDs. 16 More broadly, although left ventricular ejection fraction is currently the main risk stratification tool used to select patients for ICD therapy, 41 the majority of SCD occurs in individuals with no known cardiac disease, 42,43 with ventricular fibrillation as the major underlying mechanism. 40 …”

Section: Discussionmentioning

confidence: 99%

“…The occurrence of VA and the associated shocks in patients with ICDs is associated with increased mortality and heart failure hospitalizations despite effective termination of the arrhythmia. 16,17 ICD shocks can also damage myocardial cells and induce sympathetic responses. 16 Even if arrhythmias are promptly detected and appropriately treated, asystole and pulseless electrical activity can result.…”

Section: Introductionmentioning

confidence: 99%

“…16,17 ICD shocks can also damage myocardial cells and induce sympathetic responses. 16 Even if arrhythmias are promptly detected and appropriately treated, asystole and pulseless electrical activity can result. 18 Thus, identifying triggers of arrhythmias is important for preventing additional morbidity and mortality associated with these events.…”

Section: Introductionmentioning

confidence: 99%

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Weather and triggering of ventricular arrhythmias in patients with implantable cardioverter-defibrillators

Nguyen

Laden

Link

et al. 2013

J Expo Sci Environ Epidemiol

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Outdoor ambient weather has been hypothesized to be responsible for the seasonal distribution of cardiac arrhythmias. Because people spend most of their time indoors, we hypothesized that weather-related arrhythmia risk would be better estimated using an indoor measure or an outdoor measure that correlates well with indoor conditions, such as absolute humidity. The clinical records of 203 patients in eastern Massachusetts, USA, with an implantable cardioverter-defibrillator were abstracted for arrhythmias between 1995 and 2002. We used case-crossover methods to examine the association between weather and ventricular arrhythmia (VA). Among 84 patients who experienced 787 VAs, lower estimated indoor temperature (odds ratio (OR) = 1.16, 95% confidence interval (CI) 1.05–1.27 for a 1 °C decrease in the 24-h average) and lower absolute humidity (OR = 1.06, 95% CI 1.03–1.08 for a 0.5 g/m3 decrease in the 96-h average) were associated with increased risk. Lower outdoor temperature increased risk only in warmer months, likely attributable to the poor correlation between outdoor and indoor temperature during cooler months. These results suggest that lower temperature and drier air are associated with increased risk of VA onset among implantable cardioverter-defibrillator patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Weather and triggering of ventricular arrhythmias in patients with implantable cardioverter-defibrillators

Nguyen

Laden

Link

et al. 2013

J Expo Sci Environ Epidemiol

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show abstract

Section: Discussionmentioning

confidence: 99%

Weather and Triggering Ventricular Arrhythmias in Patients with Implantable Cardioverter Defibrillators

Nguyen¹,

Laden²,

Link³

et al. 2013

ISEE Conference Abstracts

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Outdoor ambient weather has been hypothesized to be responsible for the seasonal distribution of cardiac arrhythmias. Because people spend most of their time indoors, we hypothesized that weather-related arrhythmia risk would be better estimated using an indoor measure or an outdoor measure that correlates well with indoor conditions, such as absolute humidity. The clinical records of 203 patients in eastern Massachusetts, USA, with an implantable cardioverterdefibrillator were abstracted for arrhythmias between 1995 and 2002. We used case-crossover methods to examine the association between weather and ventricular arrhythmia (VA). Among 84 patients who experienced 787 VAs, lower estimated indoor temperature (odds ratio (OR) = 1.16, 95% confidence interval (CI) 1.05-1.27 for a 1 °C decrease in the 24-h average) and lower absolute humidity (OR = 1.06, 95% CI 1.03-1.08 for a 0.5 g/m 3 decrease in the 96-h average) were associated with increased risk. Lower outdoor temperature increased risk only in warmer months, likely attributable to the poor correlation between outdoor and indoor temperature during cooler months. These results suggest that lower temperature and drier air are associated with increased risk of VA onset among implantable cardioverter-defibrillator patients.ICDs record the onset date and time of arrhythmic events and the associated electrocardiograms (ECGs), which allows for subsequent objective review of the detected cardiac arrhythmias. Using ICD records of the date and time of arrhythmic events, we examined the association between weather and ventricular tachyarrhythmias among patients Nguyen et al.

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“…In contrast, in patients with chronic myocardial scarring, sustained monomorphic ventricular tachycardia (VT) might be initiated by a premature beat with no other participating factors 6 . In these patients, rapid termination of the arrhythmia by the ICD may prevent clinical deterioration secondary to the arrhythmia.…”

mentioning

confidence: 99%

Prognostic Significance of Implantable Defibrillator Shock: Are All Shocks Created Equal?

Freedberg

Feldman

2012

Cardiovasc electrophysiol

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Ventricular Arrhythmias in Patients With Implanted Defibrillators

Cited by 16 publications

References 45 publications

Weather and triggering of ventricular arrhythmias in patients with implantable cardioverter-defibrillators

Weather and triggering of ventricular arrhythmias in patients with implantable cardioverter-defibrillators

Weather and Triggering Ventricular Arrhythmias in Patients with Implantable Cardioverter Defibrillators

Prognostic Significance of Implantable Defibrillator Shock: Are All Shocks Created Equal?

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