BACKGROUND: Inappropriate implantable cardioverter defibrillator (ICD) shocks have been linked to a worse clinical outcome due to direct myocardial injury. HYPOTHESIS: The occurrence of ventricular tachyarrhythmia indicating progression of the underlying heart disease, but not the ICD shock itself, has prognostic impact in clinical routine. METHODS: In a retrospective study, 1117 recipients of an ICD were analyzed with respect to appropriate and inappropriate therapies and survival. RESULTS: During a mean follow-up of 2.92 years, appropriate therapy occurred in 27.7% and 54.0% of patients who had received an ICD for primary and secondary prevention of sudden cardiac death (SCD), respectively (P<0.0001). Inappropriate shock therapy occurred in 15.0% and 25.4% of patients who had received an ICD for primary and secondary prevention of SCD, respectively (P = 0.122). Appropriate ICD therapy had a strong impact on overall survival (P<0.0001), and this association was found both in primary (P<0.0001) and secondary (P = 0.002) prevention of SCD. Inappropriate ICD shocks had no impact on total mortality, neither in primary nor secondary prevention of SCD. CONCLUSIONS: Inappropriate shocks do not affect survival, in strong contrast to appropriate ICD therapy. Our study does not support the hypothesis that shock therapy in itself worsens clinical outcome. However, it confirms that appropriate ICD therapy is a warning sign and should prompt physicians to consider additional treatment strategies.
BACKGROUND: Inappropriate implantable cardioverter defibrillator (ICD) shocks have been linked to a worse clinical outcome due to direct myocardial injury. HYPOTHESIS: The occurrence of ventricular tachyarrhythmia indicating progression of the underlying heart disease, but not the ICD shock itself, has prognostic impact in clinical routine. METHODS: In a retrospective study, 1117 recipients of an ICD were analyzed with respect to appropriate and inappropriate therapies and survival. RESULTS: During a mean follow-up of 2.92 years, appropriate therapy occurred in 27.7% and 54.0% of patients who had received an ICD for primary and secondary prevention of sudden cardiac death (SCD), respectively (P<0.0001). Inappropriate shock therapy occurred in 15.0% and 25.4% of patients who had received an ICD for primary and secondary prevention of SCD, respectively (P = 0.122). Appropriate ICD therapy had a strong impact on overall survival (P<0.0001), and this association was found both in primary (P<0.0001) and secondary (P = 0.002) prevention of SCD. Inappropriate ICD shocks had no impact on total mortality, neither in primary nor secondary prevention of SCD. CONCLUSIONS: Inappropriate shocks do not affect survival, in strong contrast to appropriate ICD therapy. Our study does not support the hypothesis that shock therapy in itself worsens clinical outcome. However, it confirms that appropriate ICD therapy is a warning sign and should prompt physicians to consider additional treatment strategies.
Authors: Yehoshua C Levine; Mark K Tuttle; Michael A Rosenberg; Randal Goldberg; Jason Matos; Michelle Samuel; Daniel B Kramer; Alfred E Buxton Journal: Am J Cardiol Date: 2015-03-12 Impact factor: 2.778
Authors: Eva R Serber; Joseph L Fava; Lillian M Christon; Alfred E Buxton; Jeffrey J Goldberger; Michael R Gold; James R Rodrigue; Michael B Frisch Journal: Pacing Clin Electrophysiol Date: 2016-02-24 Impact factor: 1.976
Authors: Thomas Bitter; Klaus-Jürgen Gutleben; Georg Nölker; Zisis Dimitriadis; Christian Prinz; Jürgen Vogt; Dieter Horstkotte; Olaf Oldenburg Journal: Herzschrittmacherther Elektrophysiol Date: 2014-07-29
Authors: Milos Taborsky; Tomas Skala; Renata Aiglova; Marian Fedorco; Josef Kautzner; Tomas Jandik; Vlastimil Vancura; Ales Linhart; Martin Valek; Miloslav Novak; Petr Kala; Rostislav Polasek; Tomas Roubicek; Alexandr Schee; Gerhard Hindricks; Nikolaos Dagres; Robert Hatala; Jiri Jarkovsky Journal: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub Date: 2021-03-12 Impact factor: 1.245