The danger of inappropriate shocks in ICD patients

• Type: Summary of Presentation in an International Conference
• Date: 2012

Authors

Paiva M (Author) Other; Sousa A (Author) Other; Garcia R (Author) Other; Lebreiro A (Author) Other; Correia AS (Author) Other; Sousa C (Author) Other; Rangel I (Author) Other; Frutuoso C (Author) Other; Campos J (Author) Other; Maciel MJ (Author) FMUP

Conference proceedings International

Title: European Journal of Heart Failure Supplements

Initial page: S252

Heart Failure Congress 2012

Belgrade, 2012

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Abstract (EN): Introduction: NYHA class and the presence of atrial fibrillation (AF), have been described as predictors of inappropriate shocks (IS) in patients (pts) with implantable cardioverter defibrillator (ICD) and recent publications have verified that the occurrence of IS are associated with a higher mortality risk. Methods: A transversal study was performed on a group of pts who had an ICD implanted in our center and all-cause mortality and the occurrence of death, heart failure or ventricular arrhythmic event were analyzed. Causes of IS were reviewed (including due to SVT; AF and oversensing) and a Cox-regression survival analysis performed. Results: We analyzed 84 pts (82,1% men; mean age 61±15 years). Indications for ICD implantation were ischemic cardiomyopathy in 38 (45,2%) pts, non-ischemic in 26 (31%), Brugada syndrome in 11(13,1%) and idiopathic ventricular tachycardia in 8 (9,5%) pts. Sixty-three (75%) had 1-chamber ICD, 13 (15%) 2-chambers ICD and CRT-D in 8 (9,5%) pts. Mean ejection fraction was 31,5±15,5%, 31 (40,8%) pts had LBBB, 13 (16,5%) had AF and 21 (28,4%) pts were under anti-arrhythmic. Pts were followed for a mean time of 38±12 months. Twelve (14,3%) pts had IS. There were no differences in baseline clinical characteristics between patients with and without IS. Using Cox-regression analysis, adjusted to AF and NYHA class, pts with IS presented a higher occurrence of adverse events, defined as compound of death and cardiovascular hospitalization, when compared with pts without IS during follow-up (p=0,05). Conclusions: It is well recognized the greater morbility and mortality associated with IS in ICD patients. In our population we found the occurrence of IS to be associated with a worse outcome reinforcing the idea that mechanisms to suppress these IS are fundamental.

Language: English

Type (Professor's evaluation): Scientific

Notes: Sousa A, Mota Garcia R, Lebreiro A, Correia AS, Sousa C, Rangel I, Frutuoso C, Campos J, Maciel MJ. The danger of inappropriate shocks in ICD patients. Eur J Heart Fail Suppl 2012; 11(Suppl 1): P1323. ISSN 1567-4215. Heart Failure Congress 2012, Belgrade, 2012