Document Detail


Predictors of electrical storm in patients with idiopathic dilated cardiomyopathy--how to stratify the risk of electrical storm.
MedLine Citation:
PMID:  20679735     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Electrical storm (ES) is a serious problem in patients with an implantable cardioverter defibrillator (ICD). However, insufficient reports have indicated the predictors of ES in ICD patients with idiopathic dilated cardiomyopathy (DCM). The purpose of this study was to clarify the predictors of ES for risk stratification in DCM patients with an ICD.
METHODS AND RESULTS: Of 446 ICD patients, 53 DCM patients were included in this study. During a mean follow-up of 55+/-36 months, ES (> or =3 times appropriate ICD therapy within 24 h) occurred in 18/53 (34%) patients. According to multivariate Cox proportional hazard regression analysis, a duration of the terminal low amplitude signals of <40 microV (LAS40) (HR 1.4/10 ms increase, 95% confidence interval (CI) 1.1-2.1; P=0.0049) or root mean square voltage of the last 40 ms of the QRS complex (RMS40) (HR 0.88/1 microV, 95%CI 0.77-0.96; P=0.001) on the signal averaged electrocardiogram, and a history of atrial fibrillation (AF) before ICD implantation (HR 2.3, 95%CI 1.2-5.0; P=0.013) were independently associated with an increased risk of ES.
CONCLUSIONS: Our data indicated that a longer LAS40, lower RMS40 and history of AF before ICD implantation could strongly predict ES, and the combination of those parameters could effectively stratify the risk of ES in DCM patients.
Authors:
Masateru Takigawa; Takashi Noda; Takashi Kurita; Naohiko Aihara; Yuko Yamada; Hideo Okamura; Kazuhiro Satomi; Kazuhiro Suyama; Wataru Shimizu; Shiro Kamakura
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Publication Detail:
Type:  Journal Article     Date:  2010-07-29
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-12-22     Revised Date:  2011-02-18    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1822-9     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation
Cardiomyopathy, Dilated / complications*,  therapy
Defibrillators, Implantable / adverse effects*
Electricity / adverse effects*
Electrocardiography
Female
Follow-Up Studies
Humans
Male
Middle Aged
Predictive Value of Tests*
Proportional Hazards Models
Risk Assessment

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


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