Determinants of inappropriate implantable cardioverter-defibrillator shocks: the German Device Registry perspective.
Cardioverter
Defibrillator
Inappropriate
Shock
Journal
Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
ISSN: 1572-8595
Titre abrégé: J Interv Card Electrophysiol
Pays: Netherlands
ID NLM: 9708966
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
09
04
2019
accepted:
16
07
2019
pubmed:
4
8
2019
medline:
3
3
2020
entrez:
4
8
2019
Statut:
ppublish
Résumé
In the present study, we have focused upon rates and clinical determinants of inappropriate shock (IS) after implantable cardioverter-defibrillator (ICD). Data were collected prospectively in the German Device II Registry. A total of 783 patients were included. Three sub-groups were identified: non-shock (NS) included 725 patients (92.6%), IS 24 (3.1%), and appropriate shock (AS) 34 (4.3%). IS patients were younger (AS 68 (58-77); IS 59 (51-68); NS 66 (56-75) years; p = 0.03), had been mainly referred for primary prophylaxis (AS 42.4%; IS 70.8%; NS 67.3%; p = 0.01), had a higher resting heart rate (AS 70 (63-80); IS 80 (71-98); NS 70 (60-81) BPM; p = 0.003), had more often atrial fibrillation (AF) (AS 14.7%; IS 45.8%; NS 18.8%; p = 0.006), and shorter QRS duration (AS 100 (90-120); IS 95 (90-100); NS 120 (98-150) msec.; p = 0.001). VVI-ICD was more common in IS (AS 64.7%; IS 83.3%; NS 49.8%; p = 0.002). At a follow-up of 18.2 months (75% IQR 13.6-22.4), no deaths were observed in the IS group, one (2.9%) in the AS, and 36 (4.9%) in the NS (p = 0.9). At logistic regression, VVI-ICD implantation was the strongest IS independent determinant (OR 5.0; 95% CI 1.6-15.9; p = 0.004) together with age < 70 years (OR 4.6; CI 1.4-14.7; p = 0.009), AF at time of ICD implantation (OR 3.5; CI 1.3-9.1; p = 0.01), and resting heart rate > 70/min (OR 2.8; CI 1.0-7.3; p = 0.03). In a contemporary setting, some specific conditions such as VVI-ICD, younger age, and faster resting heart rates remain important IS determinants after ICD implantation.
Sections du résumé
BACKGROUND
BACKGROUND
In the present study, we have focused upon rates and clinical determinants of inappropriate shock (IS) after implantable cardioverter-defibrillator (ICD).
METHODS
METHODS
Data were collected prospectively in the German Device II Registry.
RESULTS
RESULTS
A total of 783 patients were included. Three sub-groups were identified: non-shock (NS) included 725 patients (92.6%), IS 24 (3.1%), and appropriate shock (AS) 34 (4.3%). IS patients were younger (AS 68 (58-77); IS 59 (51-68); NS 66 (56-75) years; p = 0.03), had been mainly referred for primary prophylaxis (AS 42.4%; IS 70.8%; NS 67.3%; p = 0.01), had a higher resting heart rate (AS 70 (63-80); IS 80 (71-98); NS 70 (60-81) BPM; p = 0.003), had more often atrial fibrillation (AF) (AS 14.7%; IS 45.8%; NS 18.8%; p = 0.006), and shorter QRS duration (AS 100 (90-120); IS 95 (90-100); NS 120 (98-150) msec.; p = 0.001). VVI-ICD was more common in IS (AS 64.7%; IS 83.3%; NS 49.8%; p = 0.002). At a follow-up of 18.2 months (75% IQR 13.6-22.4), no deaths were observed in the IS group, one (2.9%) in the AS, and 36 (4.9%) in the NS (p = 0.9). At logistic regression, VVI-ICD implantation was the strongest IS independent determinant (OR 5.0; 95% CI 1.6-15.9; p = 0.004) together with age < 70 years (OR 4.6; CI 1.4-14.7; p = 0.009), AF at time of ICD implantation (OR 3.5; CI 1.3-9.1; p = 0.01), and resting heart rate > 70/min (OR 2.8; CI 1.0-7.3; p = 0.03).
CONCLUSION
CONCLUSIONS
In a contemporary setting, some specific conditions such as VVI-ICD, younger age, and faster resting heart rates remain important IS determinants after ICD implantation.
Identifiants
pubmed: 31375974
doi: 10.1007/s10840-019-00600-4
pii: 10.1007/s10840-019-00600-4
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
71-77Subventions
Organisme : Stiftung Institut für Herzinfarktforschung
ID : xxx
Références
Circulation. 2002 Mar 26;105(12):1453-8
pubmed: 11914254
J Am Coll Cardiol. 2003 May 21;41(10):1707-12
pubmed: 12767651
N Engl J Med. 2004 May 20;350(21):2140-50
pubmed: 15152059
N Engl J Med. 2004 May 20;350(21):2151-8
pubmed: 15152060
J Am Coll Cardiol. 2004 Dec 21;44(12):2362-7
pubmed: 15607399
N Engl J Med. 2005 Jan 20;352(3):225-37
pubmed: 15659722
Circulation. 2006 Jun 27;113(25):2871-9
pubmed: 16769912
J Am Coll Cardiol. 2008 Apr 8;51(14):1357-65
pubmed: 18387436
J Am Coll Cardiol. 2011 Feb 1;57(5):556-62
pubmed: 21272746
Circ Arrhythm Electrophysiol. 2014 Oct;7(5):785-92
pubmed: 25136077
Int J Cardiol. 2015 Sep 15;195:188-94
pubmed: 26046421
Heart Rhythm. 2015 Dec;12(12):2426-33
pubmed: 26277863
Int Heart J. 2016 May 25;57(3):304-9
pubmed: 27181038
J Interv Card Electrophysiol. 2017 Dec;50(3):219-226
pubmed: 29177981
Europace. 2018 Oct 1;20(10):1621-1629
pubmed: 30137296