BACKGROUND: Patients with end-stage renal disease are at increased risk for sudden cardiac death, although the utility of implantable cardioverter-defibrillators (ICDs) in these patients is unknown. OBJECTIVES: The purpose of this study was to evaluate whether end-stage renal disease is an independent risk factor for appropriate ICD therapy for ventricular tachycardia (VT) or ventricular fibrillation (VF) and to compare the long-term survival of ICD recipients with and without end-stage renal disease. METHODS: A retrospective cohort study was performed on ICD recipients at a single center. The primary endpoint was first appropriate ICD therapy for VT/VF. The secondary endpoint was survival. RESULTS: The study included 585 patients, 19 (3.2%) of whom had end-stage renal disease prior to device implantation. Average follow-up time was 2.2 +/- 2.4 years, during which time 156 patients (26.7%) received appropriate ICD therapy. End-stage renal disease was strongly associated with appropriate ICD therapy (hazard ratio 2.30, 95% confidence interval 1.17-4.54) and remained a significant predictor following adjustment for implant indication, ejection fraction, diabetes, hypertension, and beta-blocker use. Survival was significantly shorter in the end-stage renal disease patients, with a median survival time of 3.2 +/- 0.6 (SEM) years in the dialysis cohort and 7.4 +/- 0.5 (SEM) years in those without end-stage renal disease (log rank P = .009). The majority of deaths in the end-stage renal disease cohort were due to non-device-related infection. CONCLUSION: In this cohort, end-stage renal disease was the single greatest predictor of ICD therapies for VT/VF. The survival rate was significantly shorter than that of ICD recipients without end-stage renal disease, suggesting that comorbidities in end-stage renal disease patients meeting current implant indications may reduce the survival benefit of ICD placement in this population.
BACKGROUND:Patients with end-stage renal disease are at increased risk for sudden cardiac death, although the utility of implantable cardioverter-defibrillators (ICDs) in these patients is unknown. OBJECTIVES: The purpose of this study was to evaluate whether end-stage renal disease is an independent risk factor for appropriate ICD therapy for ventricular tachycardia (VT) or ventricular fibrillation (VF) and to compare the long-term survival of ICD recipients with and without end-stage renal disease. METHODS: A retrospective cohort study was performed on ICD recipients at a single center. The primary endpoint was first appropriate ICD therapy for VT/VF. The secondary endpoint was survival. RESULTS: The study included 585 patients, 19 (3.2%) of whom had end-stage renal disease prior to device implantation. Average follow-up time was 2.2 +/- 2.4 years, during which time 156 patients (26.7%) received appropriate ICD therapy. End-stage renal disease was strongly associated with appropriate ICD therapy (hazard ratio 2.30, 95% confidence interval 1.17-4.54) and remained a significant predictor following adjustment for implant indication, ejection fraction, diabetes, hypertension, and beta-blocker use. Survival was significantly shorter in the end-stage renal diseasepatients, with a median survival time of 3.2 +/- 0.6 (SEM) years in the dialysis cohort and 7.4 +/- 0.5 (SEM) years in those without end-stage renal disease (log rank P = .009). The majority of deaths in the end-stage renal disease cohort were due to non-device-related infection. CONCLUSION: In this cohort, end-stage renal disease was the single greatest predictor of ICD therapies for VT/VF. The survival rate was significantly shorter than that of ICD recipients without end-stage renal disease, suggesting that comorbidities in end-stage renal diseasepatients meeting current implant indications may reduce the survival benefit of ICD placement in this population.
Authors: Jayson Rakesh Baman; Joseph Knapper; Zankhana Raval; Matthew E Harinstein; John J Friedewald; Kameswari Maganti; Michael J Cuttica; Michael I Abecassis; Ziad A Ali; Mihai Gheorghiade; James D Flaherty Journal: Clin J Am Soc Nephrol Date: 2019-09-25 Impact factor: 8.237
Authors: Beata Franczyk-Skóra; Anna Gluba-Brzózka; Jerzy Krzysztof Wranicz; Maciej Banach; Robert Olszewski; Jacek Rysz Journal: Int Urol Nephrol Date: 2015-05-12 Impact factor: 2.370
Authors: Kathrin Weidner; Michael Behnes; Christel Weiß; Christoph Nienaber; Linda Reiser; Armin Bollow; Gabriel Taton; Thomas Reichelt; Dominik Ellguth; Niko Engelke; Jonas Rusnak; Tobias Schupp; Seung-Hyun Kim; Christian Barth; Jorge Hoppner; Muharrem Akin; Kambis Mashayekhi; Martin Borggrefe; Ibrahim Akin Journal: Heart Vessels Date: 2019-05-10 Impact factor: 2.037
Authors: David D Daly; Anbukarasi Maran; J Madison Hyer; Frederick Funke; Ashley Waring; Frank A Cuoco; J Lacy Sturdivant; Robert B Leman; Michael R Gold Journal: Pacing Clin Electrophysiol Date: 2016-06-07 Impact factor: 1.976
Authors: Brian J Schietinger; Glenn M Brammer; Hongkun Wang; John M Christopher; Katherine W Kwon; Amy J Mangrum; J Michael Mangrum; Christopher M Kramer Journal: JACC Cardiovasc Imaging Date: 2008-07