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Comparison Between Atrial Fibrillation-Triggered Implantable Cardioverter-Defibrillator (ICD) Shocks and Inappropriate Shocks Caused by Lead Failure:: Different Impact on Prognosis in Clinical Practice.
MedLine Citation:
PMID:  22313314     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Prognostic Impact of Inappropriate Shocks. Introduction: Recent studies suggest a worse impact of inappropriate shock therapies on the outcome of patients with an implantable cardioverter-defibrillator (ICD). However, it is not known whether the worse impact is attributed to the ICD shock itself or due to the underlying heart disease. The aim of the study was to evaluate the impact of inappropriate ICD shocks on clinical outcome by comparing ICD shocks triggered by atrial fibrillation (AF) with shocks caused by lead failure. Methods and Results: A total of 1,411 consecutive patients of the prospective single-center ICD-registry Ludwigshafen who underwent an ICD implantation between 1992 and 2008 for primary or secondary prevention of sudden cardiac death were analyzed. During the median follow-up of 3 years, 297 (21%) patients experienced inappropriate ICD shocks. Sixty percent of patients had inappropriate shocks due to AF and 24% due to lead defect or T-wave oversensing. Multiple ICD shocks (≥2) triggered by AF were associated with a worse prognosis, whereas a single shock due to AF or 1 or multiple shocks resulting from lead failure were not. ICD shocks caused by AF occurred more often in tandem with a serious adverse event than in patients with a lead failure (15% vs 6%, P < 0.05). Conclusion: Multiple ICD shocks triggered by AF are associated with a worse prognosis in ICD patients, whereas a single shock due to AF or shocks resulting from lead failure are not. These data support that the ICD shock itself has no worse impact on the outcome of ICD patients. (J Cardiovasc Electrophysiol, Vol. pp. 1-6).
Authors:
Thomas Kleemann; Matthias Hochadel; Margit Strauss; Alexandros Skarlos; Karlheinz Seidl; Ralf Zahn
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-7
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Wiley Periodicals, Inc.
Affiliation:
Ludwigshafen Department of Cardiology/Clinical Electrophysiology, Klinikum Ludwigshafen, Germany Institut für Herzinfarktforschung Ludwigshafen an der Universität Heidelberg, Ludwigshafen, Germany Ingolstadt Med Clinic IV Cardiology/Clinical Electrophysiology, Klinikum Ingolstadt, Ingolstadt, Germany.
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