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INAPPROPRIATE IMPLANTABLE CARDIOVERTER DEFIBRILLATOR SHOCKS INCREASE MORTALITY
A11.E102 JACC March 9, 2010 Volume 55, issue 10A
CARDIAC ARRHYTHMIAS INAPPROPRIATE IMPLANTABLE CARDIOVERTER DEFIBRILLATOR SHOCKS INCREASE MORTALITY ACC Poster Contributions Georgia World Congress Center, Hall B5 Monday, March 15, 2010, 3:30 p.m.-4:30 p.m.
Session Title: Defibrillation/Implantable Antiarrhythmia Devices Abstract Category: Defibrillation/Implantable Antiarrhythmia Devices Presentation Number: 1189-131 Authors: Johannes B. Van Rees, C. Jan Willem Borleffs, Mihály K. de Bie, Theo Stijnen, Lieselot van Erven, Jeroen J. Bax, Martin J. Schalij, Leiden University Medical Center, Leiden, The Netherlands Background: Despite the benefits of implantable cardioverter defibrillator (ICD) therapy, inappropriate shocks continue to be a significant drawback. However, the prognostic importance of inappropriate shocks outside the setting of a clinical trial remains unclear. The aim of this study was to assess the incidence, predictors and outcome of inappropriate shocks in ICD patients. Methods: From 1996 to 2006, all recipients of defibrillator devices equipped with intracardiac electrogram storage were included in the current analysis and clinically assessed at implantation. During follow-up, the occurrence of inappropriate ICD shocks and all-cause mortality were noted. Results: A total of 1,544 ICD patients (79% male, 61 ± 13 years) were included in the analysis. During the follow-up period of 41 ± 18 months, 13% experienced one or more inappropriate shocks. The cumulative incidence steadily increased to 18% at 5 years follow-up. Baseline predictors for the occurrence of inappropriate shocks consisted of history of atrial fibrillation (HR 2.0, p<0.01), age below 70 years (HR 1.8, p<0.01) and no statin usage (HR 1.3, p=0.10). Experiencing a single inappropriate shock resulted in an increased risk for all-cause mortality (HR 1.6, p=0.01). Mortality risk increased with every subsequent shock, up to a HR of 3.7 after 5 inappropriate shocks. Conclusions: In a large cohort of ICD patients, inappropriate shocks were common. Most important finding is the association between inappropriate shocks and mortality.
CARDIAC ARRHYTHMIAS INAPPROPRIATE IMPLANTABLE CARDIOVERTER DEFIBRILLATOR SHOCKS INCREASE MORTALITY ACC Poster Contributions Georgia World Congress Center, Hall B5 Monday, March 15, 2010, 3:30 p.m.-4:30 p.m.
Session Title: Defibrillation/Implantable Antiarrhythmia Devices Abstract Category: Defibrillation/Implantable Antiarrhythmia Devices Presentation Number: 1189-131 Authors: Johannes B. Van Rees, C. Jan Willem Borleffs, Mihály K. de Bie, Theo Stijnen, Lieselot van Erven, Jeroen J. Bax, Martin J. Schalij, Leiden University Medical Center, Leiden, The Netherlands Background: Despite the benefits of implantable cardioverter defibrillator (ICD) therapy, inappropriate shocks continue to be a significant drawback. However, the prognostic importance of inappropriate shocks outside the setting of a clinical trial remains unclear. The aim of this study was to assess the incidence, predictors and outcome of inappropriate shocks in ICD patients. Methods: From 1996 to 2006, all recipients of defibrillator devices equipped with intracardiac electrogram storage were included in the current analysis and clinically assessed at implantation. During follow-up, the occurrence of inappropriate ICD shocks and all-cause mortality were noted. Results: A total of 1,544 ICD patients (79% male, 61 ± 13 years) were included in the analysis. During the follow-up period of 41 ± 18 months, 13% experienced one or more inappropriate shocks. The cumulative incidence steadily increased to 18% at 5 years follow-up. Baseline predictors for the occurrence of inappropriate shocks consisted of history of atrial fibrillation (HR 2.0, p<0.01), age below 70 years (HR 1.8, p<0.01) and no statin usage (HR 1.3, p=0.10). Experiencing a single inappropriate shock resulted in an increased risk for all-cause mortality (HR 1.6, p=0.01). Mortality risk increased with every subsequent shock, up to a HR of 3.7 after 5 inappropriate shocks. Conclusions: In a large cohort of ICD patients, inappropriate shocks were common. Most important finding is the association between inappropriate shocks and mortality.