| Role of implantable cardioverter defibrillator therapy in patients with acquired long QT syndrome: a long-term follow-up. | |
| | |
MedLine Citation:
|
PMID: 21979994 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
AIMS: The use of implantable cardioverter defibrillators (ICD) in patients with torsade de pointes (TdP) and ventricular fibrillation in the presence of acquired long QT syndrome (aLQTS) is under debate, partly due to the fact that aLQTS is potentially reversible and currently no long-term follow-up data are available. We aimed to evaluate the long-term follow-up of patients with acquired long QT syndrome (aLQTS) who had received an implantable cardioverter defibrillator (ICD) for secondary prevention of sudden cardiac arrest (SCA). METHOD AND RESULTS: Over a 10 year period, 43 patients with an ICD after survived cardiac arrest (SCA) due to an aLQTS were included [female n= 27 (63%); mean age 61 ± 16 years]. There was no clinical evidence for congenital LQTS (Schwartz score 1.25 ± 0.8). Structural heart disease was present in 29 patients (47%; ischaemic n= 13; dilated cardiomyopathy n= 9; mean EF 41%± 12). The most common proarrhythmic trigger happened to be antiarrhythmic drugs (n= 34; 79%). Other triggers included contrast agent (n= 1), haloperidol (n= 2), severe hypokalaemia (n= 2), drug abuse/alcohol (n= 2), and mere severe bradycardia (n= 2). Under trigger QTc interval measured 536 ± 58 vs. 438 ± 33 ms without trigger (P< 0.001). During a mean follow-up of 84 ± 55 months, appropriate shocks occurred in 19 patients (44%); inappropriate shocks in 13 patients (30%; only inappropriate n= 3). Appropriate shocks were almost as common in patients without as in those with structural heart disease (35 vs. 48%; P= 0.32). None of the patients were re-exposed to the initial trigger during the follow-up period. Beta-blocker medication did not prevent ICD shocks (12 of 19 vs. 11 of 24 on medication). ConcluSION: Appropriate ICD shocks are a common finding in patients with aLQTS and SCA irrespective of the underlying cause or structural heart disease. Thus, even in the presence of relevant acquired proarrhythmia ICD may be beneficial. |
| | |
Authors:
|
Gerold Mönnig; Julia Köbe; Andreas Löher; Kristina Wasmer; Peter Milberg; Stephan Zellerhoff; Christian Pott; Sven Zumhagen; Razvan Radu; Hans H Scheld; Wilhelm Haverkamp; Eric Schulze-Bahr; Lars Eckardt |
Related Documents
:
|
22612914 - Right atrial remodeling is more advanced in patients with atrial flutter than with atri... 22026314 - Papillary muscle sandwich plasty for the treatment of functional mitral valve regurgita... 21740454 - Adrenergic and cardiac dysfunction in primary hyperparathyroidism. 21817934 - Intracochlear schwannomas confined to the otic capsule. 18279754 - Metabolic testing in the pediatric epilepsy unit. 1279614 - Antiarrhythmic efficacy of ethacizine assessed by programmed electrical stimulation in ... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2011-10-06 |
Journal Detail:
|
Title: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology Volume: 14 ISSN: 1532-2092 ISO Abbreviation: Europace Publication Date: 2012 Mar |
Date Detail:
|
Created Date: 2012-02-22 Completed Date: 2012-07-11 Revised Date: 2013-05-20 |
Medline Journal Info:
|
Nlm Unique ID: 100883649 Medline TA: Europace Country: England |
Other Details:
|
Languages: eng Pagination: 396-401 Citation Subset: IM |
Affiliation:
|
Department of Cardiology and Angiology, Division of Experimental and Clinical Electrophysiology, University Hospital Münster, Münster, Germany. moennig@uni-muenster.de |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adrenergic beta-Antagonists
/
therapeutic use Adult Aged Anti-Arrhythmia Agents / therapeutic use Death, Sudden, Cardiac / prevention & control Defibrillators, Implantable* Female Follow-Up Studies Heart Diseases / therapy Humans Long QT Syndrome / drug therapy, therapy* Male Middle Aged Prospective Studies Retrospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Adrenergic beta-Antagonists; 0/Anti-Arrhythmia Agents |
| Comments/Corrections | |
Comment In:
|
Europace. 2012 Mar;14(3):310-1
[PMID:
22106361
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Ventricular arrhythmias originating from the aortomitral continuity: an uncommon variant of left ven...
Next Document: Use of implantable loop recorders in patients with Brugada syndrome and suspected risk of ventricula...