Document Detail


Association Between Left Ventricular Ejection Fraction Post-Cardiac Resynchronization treatment and Subsequent ICD Therapy for Sustained Ventricular Tachyarrhythmias.
MedLine Citation:
PMID:  23443618     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -While cardiac resynchronization therapy (CRT) can improve the left ventricular ejection fraction (LVEF), it is not known whether a specific level of improvement will predict future implantable cardioverter defibrillator (ICD) therapy. METHODS AND RESULTS: -CRT-defibrillator (CRT-D) was implanted in 423 patients at one institution between 10/02/2001 through 1/19/2007. A retrospective analysis was performed to evaluate the relationship between post-CRT-D LVEF and ICD therapy for ventricular tachyarrhythmias. A landmark population of 270 patients, with post-CRT-D LVEF measured and no ICD therapy within 1 year of device implantation, was followed for subsequent outcomes. Of these, 22 (8.2%) had subsequent appropriate ICD therapy over a median follow-up of 1.5 years. The estimated 2 year risk of appropriate ICD therapy is 3.0% (95% CI 0-6.3%), 2.1% (95% CI 0-5.0%) and 1.5% (95% CI 0-3.9%) for post-CRT-D LVEF of 45%, 50% and 55%, respectively. In patients with a primary prevention indication for CRT-D, the estimated 2 year risk is 3.3% (95% CI 0-7.3%), 2.5% (95% CI 0-6.1%), and 1.9% (95% CI 0-5.1%) for post-CRT-D LVEF of 45%, 50% and 55%, respectively. CONCLUSIONS: -When a CRT responder demonstrates near normalization in LVEF to 45% or more, the incidence of ICD therapy for ventricular arrhythmias becomes low. Future studies are needed to determine whether an ICD is still needed in some of these patients at the time of generator replacement.
Authors:
Joseph A Manfredi; Sana M Al-Khatib; Linda K Shaw; Laine Thomas; Richard I Fogel; Benzy Padanilam; David Rardon; Rosh Vatthyam; Lee W Gemma; Keith Golden; Eric N Prystowsky
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-26
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  -     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1AnMed Arrhythmia Specialists, Anderson, SC.
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