Document Detail


A history of heart failure predicts arrhythmia treatment efficacy: data from the Antiarrythmics versus Implantable Defibrillators (AVID) study.
MedLine Citation:
PMID:  16996848     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In survivors of life-threatening ventricular tachycardia (VT), a history of CHF (HxCHF) before the VT episode may provide different prognostic information than their measured left ventricular ejection fraction (LVEF). METHODS: We evaluated outcomes from patients in the AVID study. Patients were included in the study if they presented with ventricular fibrillation, VT with syncope or VT with hemodynamic compromise, and LVEF < or = 40%. Treatment options included implantable cardioverter defibrillator (ICD) or antiarrhythmic drugs (AAD), usually amiodarone. RESULTS: As expected, a HxCHF is associated with an increased and high risk of arrhythmic and nonarrhythmic death. However, an interaction was observed between arrhythmia treatment (ICD or AAD) and HxCHF status: the survival advantage with an ICD, as compared with AAD therapy, is largely restricted to HxCHF patients. CONCLUSIONS: The ICD is no better than AAD therapy in preventing arrhythmic death in patients with no HxCHF. In this data set, a HxCHF is somewhat more accurate in predicting prognosis and the response to therapy than a reduced LVEF.
Authors:
Michael A Brodsky; John McAnulty; Douglas P Zipes; Christina Baessler; Alfred P Hallstrom;
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  152     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-25     Completed Date:  2006-10-18     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:  724-30     Citation Subset:  AIM; IM    
Affiliation:
Kaiser Permanente, Honolulu, HI.
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MeSH Terms
Descriptor/Qualifier:
Aged
Amiodarone / therapeutic use
Anti-Arrhythmia Agents / therapeutic use*
Arrhythmias, Cardiac / complications*,  mortality,  therapy*
Defibrillators, Implantable*
Female
Heart Failure / complications*,  mortality
Humans
Male
Medical Records*
Middle Aged
Multicenter Studies as Topic
Prognosis
Randomized Controlled Trials as Topic
Stroke Volume
Survival Analysis
Treatment Outcome
Ventricular Function, Left
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 1951-25-3/Amiodarone

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


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