Clinical factors associated with baseline history of atrial fibrillation and subsequent clinical outcomes following initial implantable cardioverter-defibrillator placement.
atrial fibrillation
heart failure
implantable cardioverter-defibrillator
inappropriate shock
Journal
Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
19
01
2020
revised:
28
03
2020
accepted:
12
04
2020
pubmed:
17
4
2020
medline:
10
8
2021
entrez:
17
4
2020
Statut:
ppublish
Résumé
Atrial fibrillation (AF) is frequently present in patients with heart failure (HF) and an implantable cardioverter-defibrillator (ICD). This study aims to identify clinical factors associated with a baseline history of AF in ICD recipients, and compares subsequent clinical outcomes in those with and without a baseline history of AF. We studied 566 consecutive first-time ICD recipients at an academic center between 2011 and 2018. Logistic regression multivariable analyses were used to identify clinical factors associated with a baseline history of AF at the time of ICD implant. Cox-proportional hazard regression models were constructed for multivariate analysis to examine associations between a baseline history of AF with subsequent clinical outcomes, including ICD therapies, HF readmission, and all-cause mortality. Of all patients, 201 (36%) had a baseline history of AF at the time of ICD implant. In multivariate analyses, clinical factors associated with a baseline history of AF included hypertension, valvular heart disease, body weight, PR interval, and serum creatinine level. After multivariate adjustment for potential confounders, a baseline history of AF was associated with an increased risk of anti-tachycardia pacing (HR = 1.84, 95% CI = 1.19-2.85, P = .006), appropriate ICD shocks (HR = 1.80, 95% CI = 1.05-3.09, P = .032), and inappropriate ICD shocks (HR = 3.72, 95% CI = 1.7-7.77, P = .0001), but not other adverse outcomes. Among first-time ICD recipients, specific clinical characteristics were associated with a baseline history of AF at the time of ICD implant. After adjustment for potential confounders, a baseline history of AF was associated with a higher risk of all ICD therapies in follow-up.
Sections du résumé
BACKGROUND
Atrial fibrillation (AF) is frequently present in patients with heart failure (HF) and an implantable cardioverter-defibrillator (ICD). This study aims to identify clinical factors associated with a baseline history of AF in ICD recipients, and compares subsequent clinical outcomes in those with and without a baseline history of AF.
METHODS
We studied 566 consecutive first-time ICD recipients at an academic center between 2011 and 2018. Logistic regression multivariable analyses were used to identify clinical factors associated with a baseline history of AF at the time of ICD implant. Cox-proportional hazard regression models were constructed for multivariate analysis to examine associations between a baseline history of AF with subsequent clinical outcomes, including ICD therapies, HF readmission, and all-cause mortality.
RESULTS
Of all patients, 201 (36%) had a baseline history of AF at the time of ICD implant. In multivariate analyses, clinical factors associated with a baseline history of AF included hypertension, valvular heart disease, body weight, PR interval, and serum creatinine level. After multivariate adjustment for potential confounders, a baseline history of AF was associated with an increased risk of anti-tachycardia pacing (HR = 1.84, 95% CI = 1.19-2.85, P = .006), appropriate ICD shocks (HR = 1.80, 95% CI = 1.05-3.09, P = .032), and inappropriate ICD shocks (HR = 3.72, 95% CI = 1.7-7.77, P = .0001), but not other adverse outcomes.
CONCLUSION
Among first-time ICD recipients, specific clinical characteristics were associated with a baseline history of AF at the time of ICD implant. After adjustment for potential confounders, a baseline history of AF was associated with a higher risk of all ICD therapies in follow-up.
Identifiants
pubmed: 32297348
doi: 10.1111/pace.13919
pmc: PMC7299732
mid: NIHMS1595205
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
542-550Subventions
Organisme : American Heart Association-American Stroke Association
ID : 19CDA34760021
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2 TR001444
Pays : United States
Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Circulation. 2016 Feb 2;133(5):484-92
pubmed: 26746177
Int J Cardiol. 2014 Aug 1;175(2):328-32
pubmed: 24985070
Europace. 2015 Aug;17 Suppl 4:iv1-72
pubmed: 26286028
J Am Coll Cardiol. 2008 Apr 8;51(14):1357-65
pubmed: 18387436
Am Heart J. 2007 Jan;153(1):120-6
pubmed: 17174649
J Am Coll Cardiol. 2010 Mar 2;55(9):879-85
pubmed: 20185038
Heart Rhythm. 2015 Jun;12(6):1192-200
pubmed: 25701774
Europace. 2006 Aug;8(8):566-72
pubmed: 16864611
Heart Rhythm. 2017 Dec;14(12):1820-1825
pubmed: 28893549
JAMA. 2001 May 9;285(18):2370-5
pubmed: 11343485
Heart Rhythm. 2006 Jun;3(6):631-7
pubmed: 16731460
Circulation. 2014 Dec 2;130(23):e199-267
pubmed: 24682347
Heart Rhythm. 2006 Apr;3(4):470-3
pubmed: 16567298
N Engl J Med. 2008 Sep 4;359(10):1009-17
pubmed: 18768944
J Am Coll Cardiol. 2002 Jan 2;39(1):60-9
pubmed: 11755288
Heart Rhythm. 2013 Apr;10(4):e59-65
pubmed: 23403056
N Engl J Med. 2012 Dec 13;367(24):2275-83
pubmed: 23131066
JAMA Intern Med. 2013 May 27;173(10):859-65
pubmed: 23546173
Eur J Heart Fail. 2010 Oct;12(10):1101-10
pubmed: 20861134
Am J Cardiol. 2003 Mar 20;91(6A):2D-8D
pubmed: 12670636
J Am Coll Cardiol. 2011 Feb 1;57(5):556-62
pubmed: 21272746
J Am Coll Cardiol. 2013 Mar 26;61(12):1318-68
pubmed: 23453819
J Am Coll Cardiol. 2013 Oct 15;62(16):e147-239
pubmed: 23747642
N Engl J Med. 2008 Oct 23;359(17):1778-85
pubmed: 18946063