Document Detail


Implantable cardioverter-defibrillator therapy and risk of congestive heart failure or death in MADIT II patients with atrial fibrillation.
MedLine Citation:
PMID:  16731460     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Atrial fibrillation (AF) contributes to increased risk of morbidity and mortality. Data regarding the effectiveness of implantable cardioverter-defibrillator (ICD) therapy in AF patients are limited. OBJECTIVES: The purpose of this study was to evaluate the effectiveness of ICD therapy in patients with AF enrolled in the Multicenter Automatic Defibrillator Implantation Trial II (MADIT II) and to identify their risk for the combined endpoint of hospitalization for congestive heart failure or death. METHODS: The MADIT II cohort served as the source for data on the clinical course, cardiac events, and effectiveness of ICD therapy in AF patients. RESULTS: AF was found as baseline rhythm at enrollment in 102 (8%) MADIT II patients. In comparison to 1,007 patients in sinus rhythm, AF patients were older, more frequently were males, had wider QRS complex, and had higher blood urea nitrogen and creatinine levels (P <.05 for all parameters). ICD therapy was effective in reducing 2-year mortality in AF patients from 39% in 41 conventionally treated patients to 22% in 61 ICD-treated patients (hazard ratio = 0.51, P = .079). However, the combined endpoint of hospitalization for heart failure or death at 2 years was 69% and 59%, respectively (NS). AF was predictive for the combined endpoint of heart failure hospitalization or death (hazard ratio = 1.68, P = .040). New-onset AF in patients with baseline sinus rhythm was associated with increased risk of mortality (hazard ratio = 2.70, P <.001). CONCLUSION: MADIT II patients with AF benefit from ICD therapy, which reduces their mortality. MADIT II patients with AF are at high risk for developing heart failure.
Authors:
Wojciech Zareba; Jonathan S Steinberg; Scott McNitt; James P Daubert; Katarzyna Piotrowicz; Arthur J Moss;
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-02-28
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  3     ISSN:  1547-5271     ISO Abbreviation:  Heart Rhythm     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-29     Completed Date:  2006-11-01     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  631-7     Citation Subset:  IM    
Affiliation:
Cardiology Unit, Department of Medicine, University of Rochester Medical Center, New York 14642, USA. wojciech.zareba@heart.rochester.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / complications,  mortality,  therapy*
Clinical Trials as Topic
Defibrillators, Implantable*
Female
Heart Failure / etiology,  prevention & control*
Hospitalization
Humans
Male
Retrospective Studies
Risk Factors
Survival Analysis
Comments/Corrections
Comment In:
Heart Rhythm. 2006 Jun;3(6):638-9   [PMID:  16731461 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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