Document Detail


Over 10 years with an implantable cardioverter-defibrillator - a long term follow-up of 60 patients.
MedLine Citation:
PMID:  20859894     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Transvenous implantable cardioverter-defibrillators (ICD) have been implanted in Poland since 1995. As the method spreads it is important to consider its long-term benefits and disadvantages.
AIM: To assess survival, efficacy and complication rate in ICD patients, who received the device more than ten years earlier.
METHODS: Retrospective analysis of 60 ICD patients implanted between 1995-1999.
RESULTS: There were 42 (70%) males, mean age 50.6 ± 16.4 years. In 59 patients ICD was implanted for sudden cardiac death (SCD) secondary prevention. Thirty eight patients (34 M, 63.3%) had coronary artery disease (CAD). The CAD was diagnosed in 89.5% of males and 10.5% of females (p〈 0.0001). Mean follow-up time was 75.4 ± 34.7 months. During this time 22 patients died (37%, 19 M, 3 F). Three deaths were SCD. Mean one-year mortality was 6.7%. Deaths were more frequent among males: 45.2% vs 16.7%, p〈 0.005. In CAD mortality was higher than in non-CAD patients (50% vs 13.6%, p〈 0.005). Appropriate ICD discharges in the ventricular fibrillation (VF) zone occurred in 35 (58%) patients, and in ventricular tachycardia (VT) zone - in 26 (43%) patients. Mean intervention rate per year was 3.7 for VF and 0.6 for VT. Complications occurred in 27 (45%) patients and 5 (8%) of them had no ICD intervention during follow-up. In 5 patients more than one complication was diagnosed. There were inappropriate discharges in 15 (25%) patients, 11 (18%) had electrical storm, and ICD-related infections were noted in 3 (5%) patients. During the perioperative period, lead revisions were done in 4 patients; in 3 with discharges induced by T-wave oversensing and in one with lead dislocation. Four cases of lead failure occurred during follow-up, requiring new lead implantation. In 4 patients, electrical storm (3 patients) and supraventricular tachycardia with ICD discharges (1 patient) were treated with radiofrequency ablation. Only 10 (17%) patients did not demonstrate any ICD interventions or ICD-related complications.
CONCLUSIONS: 1. ICD interventions caused by malignant ventricular arrhythmias occurred in 75% patients with the device implanted more than 10 years earlier. 2. Almost a half of the analysed population suffered from complications and side effects related to implanted ICD and they were present in 8% of subjects without ICD intervention. Neither ICD interventions nor device-related adverse events were recorded in 17% of patients.
Authors:
Maciej Sterliński; Andrzej Przybylski; Katarzyna Gepner; Paweł Syska; Aleksander Maciag; Michał Lewandowski; Ilona Kowalik; Mariusz Pytkowski; Ewa Sitkowska-Rysiak; Jerzy Lichomski; Hanna Szwed; Zygmunt Sadowski
Related Documents :
2644794 - A prospective comparison of programmed ventricular stimulation with triple extrastimuli...
18364664 - Arrhythmogenic right ventricular dysplasia/cardiomyopathy: clinical profile of four pat...
10089834 - Single-chamber versus dual-chamber implantable cardioverter defibrillators: indications...
15309004 - Detection of asymptomatic arrhythmias in unexplained syncope.
9581254 - Level of physical activity in elderly patients after hemiarthroplasty for three- and fo...
24505094 - Upregulation of circulating components of the alternative renin-angiotensin system in i...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kardiologia polska     Volume:  68     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-22     Completed Date:  2010-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  1023-9     Citation Subset:  IM    
Affiliation:
Institute of Cardiology, Warsaw, Poland. msterlinski@poczta.onet.pl
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coronary Artery Disease / therapy*
Death, Sudden, Cardiac / prevention & control*
Defibrillators, Implantable / adverse effects*,  statistics & numerical data
Equipment Failure Analysis*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Poland
Retrospective Studies
Risk Factors
Severity of Illness Index
Survival Analysis
Tachycardia, Ventricular / etiology,  mortality*
Time Factors
Ventricular Fibrillation / etiology,  mortality*
Comments/Corrections
Comment In:
Kardiol Pol. 2010 Sep;68(9):1030-1   [PMID:  20859895 ]

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


Previous Document:  Oral versus intravenous hydration and renal function in diabetic patients undergoing percutaneous co...
Next Document:  Prevalence of classical risk factors in Polish women with premature coronary artery disease.