| Implantable cardioverter-defibrillators in tetralogy of Fallot. | |
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MedLine Citation:
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PMID: 18172030 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Tetralogy of Fallot is the most common form of congenital heart disease in implantable cardioverter-defibrillator (ICD) recipients, yet little is known about the value of ICDs in this patient population. METHODS AND RESULTS: We conducted a multicenter cohort study in high-risk patients with Tetralogy of Fallot to determine actuarial rates of ICD discharges, identify risk factors, and characterize ICD-related complications. A total of 121 patients (median age 33.3 years; 59.5% male) were enrolled from 11 sites and followed up for a median of 3.7 years. ICDs were implanted for primary prevention in 68 patients (56.2%) and for secondary prevention in 53 (43.8%), defined by clinical sustained ventricular tachyarrhythmia or resuscitated sudden death. Overall, 37 patients (30.6%) received at least 1 appropriate and effective ICD discharge, with a median ventricular tachyarrhythmia rate of 213 bpm. Annual actuarial rates of appropriate ICD shocks were 7.7% and 9.8% in primary and secondary prevention, respectively (P=0.11). A higher left ventricular end-diastolic pressure (hazard ratio 1.3 per mm Hg, P=0.004) and nonsustained ventricular tachycardia (hazard ratio 3.7, P=0.023) independently predicted appropriate ICD shocks in primary prevention. Inappropriate shocks occurred in 5.8% of patients yearly. Additionally, 36 patients (29.8%) experienced complications, of which 6 (5.0%) were acute, 25 (20.7%) were late lead-related, and 7 (5.8%) were late generator-related complications. Nine patients died during follow-up, which corresponds to an actuarial annual mortality rate of 2.2%, which did not differ between the primary and secondary prevention groups. CONCLUSIONS: Patients with tetralogy of Fallot and ICDs for primary and secondary prevention experience high rates of appropriate and effective shocks; however, inappropriate shocks and late lead-related complications are common. |
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Authors:
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Paul Khairy; Louise Harris; Michael J Landzberg; Sangeetha Viswanathan; Amanda Barlow; Michael A Gatzoulis; Susan M Fernandes; Luc Beauchesne; Judith Therrien; Philippe Chetaille; Elaine Gordon; Isabelle Vonder Muhll; Frank Cecchin |
Publication Detail:
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Type: Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2008-01-02 |
Journal Detail:
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Title: Circulation Volume: 117 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-01-23 Completed Date: 2008-02-25 Revised Date: 2009-07-01 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 363-70 Citation Subset: AIM; IM |
Affiliation:
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Adult Congenital Heart Center, Montreal Heart Institute, 5000 Bélanger St, Montreal, Quebec, Canada H1T 1C8. paul.khairy@umontreal.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Pressure Cohort Studies Death, Sudden, Cardiac Defibrillators, Implantable* Electric Countershock Female Humans Male Retrospective Studies Tachycardia, Ventricular Tetralogy of Fallot / therapy* |
| Comments/Corrections | |
Comment In:
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Curr Cardiol Rep. 2009 Jul;11(4):241-2
[PMID:
19563722
]
Circulation. 2008 Jul 29;118(5):e99; author reply e100 [PMID: 18663095 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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