Document Detail


Incidence of implantable defibrillator discharges after coronary revascularization in survivors of ischemic sudden cardiac death.
MedLine Citation:
PMID:  7631607     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Coronary revascularization has been suggested as sole therapy for secondary prevention of sudden cardiac arrest associated with ischemia. The use of implantable defibrillators (ICD) in combination with coronary revascularization for this patient population is unclear. Among 412 consecutive patients receiving an ICD, 23 (6%) were identified as sudden cardiac arrest survivors who were noninducible with programmed stimulation and had unstable angina or ischemia on a functional study; they underwent successful coronary revascularization. During a follow-up of 34 +/- 18 months, 10 (43%) of the 23 patients received ICD shocks (8 +/- 8 per patient, range 1 to 22 shocks), and nine of the 10 patients had syncope/presyncope associated with at least one ICD discharge. Patients with ICD discharges were compared with those without ICD discharges, and no clinical characteristics were statistically different between the two groups. In conclusion, revascularization alone may be inadequate therapy for survivors of sudden cardiac arrest associated with ischemia who are noninducible with programmed stimulation, and clinical variables cannot predict which patients are likely to have recurrent malignant ventricular arrhythmias.
Authors:
E G Daoud; M Niebauer; W H Kou; K C Man; L Horwood; F Morady; S A Strickberger
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  130     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1995 Aug 
Date Detail:
Created Date:  1995-09-05     Completed Date:  1995-09-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  277-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University of Michigan Hospital, Ann Arbor 48109, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Arrhythmias, Cardiac / etiology,  prevention & control
Chi-Square Distribution
Coronary Angiography
Coronary Artery Bypass
Death, Sudden, Cardiac / etiology,  prevention & control*
Defibrillators, Implantable*
Electrophysiology
Exercise Test
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Ischemia / complications,  diagnosis,  therapy*
Myocardial Revascularization*
Patient Discharge / statistics & numerical data*
Retrospective Studies
Survivors

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


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