Title :

Long-term outcome of implantable cardioverter-defibrillator implantation in secondary prevention of sudden cardiac death

Author(s) :

Boule, Stéphane [Auteur]
Semichon, Marc [Auteur]
Guedon-Moreau, Laurence [Auteur]
Drumez, Elodie [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Kouakam, Claude [Auteur]
Marquie, Christelle [Auteur]
Brigadeau, François [Auteur]
Kacet, Salem [Auteur]
Potelle, Charlotte [Auteur]
Escande, William [Auteur]
Souissi, Zouheir [Auteur]
Lacroix, Dominique [Auteur]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Klug, Didier [Auteur]

Journal title :

Archives of cardiovascular diseases

Abbreviated title :

Arch. Cardiovasc. Dis.

Volume number :

109

Pages :

517-526

Publication date :

2016-10-01

ISSN :

1875-2136

English keyword(s) :

Ventricular fibrillation
Secondary prevention
Implantable cardioverter-defibrillator
Sudden cardiac death
Ventricular tachycardia

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Little is known about the long-term outcomes of patients who receive an implantable cardioverter-defibrillator (ICD) for purely secondary prevention indications. OBJECTIVE: To assess the rates and predictors ...
Show more >BACKGROUND: Little is known about the long-term outcomes of patients who receive an implantable cardioverter-defibrillator (ICD) for purely secondary prevention indications. OBJECTIVE: To assess the rates and predictors of appropriate therapies over a very long-term follow-up period in this population. METHODS: Between June 2003 and August 2006, 239 consecutive patients with structural left ventricular disease and a secondary prophylaxis indication for ICD therapy (survivors of life-threatening ventricular tachyarrhythmias) were prospectively enrolled. An extended follow-up of these patients was carried out. The primary endpoint was the occurrence of appropriate device therapy. Secondary endpoints were all-cause death, electrical storm and inappropriate therapy. RESULTS: The study population consisted of 239 patients (90% men; mean age 64±12 years; 72% ischaemic cardiomyopathy; left ventricular ejection fraction 37±12%). During a median follow-up of 7.8 (3.5-9.3) years, appropriate device therapy occurred in 139 (58.2%) patients. Death occurred in 141 patients (59%), electrical storm in 73 (30.5%) and inappropriate therapy in 42 (17.6%). Multivariable analysis identified patients whose presenting arrhythmia was ventricular fibrillation as being less likely to require appropriate device therapy than those whose presenting arrhythmia was ventricular tachycardia (sub-hazard ratio 0.62, 95% confidence interval 0.40-0.97; P=0.04). Independent predictors of all-cause death were age at implantation (P<0.0001), wide QRS complexes (P=0.024), creatinine concentration (P=0.0002) and B-type natriuretic peptide at implantation (P=0.0001). CONCLUSIONS: Secondary prevention ICD recipients exhibit a high risk of appropriate device therapy and death over prolonged follow-up. Patients who presented initially with ventricular fibrillation were less likely to require the delivery of appropriate device therapy.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-12-09T18:15:39Z
2021-05-17T07:51:47Z