Title :

Predictors of subcutaneous ICD shocks and prognostic impact in patients with structural heart disease.

Author(s) :

Ninni, Sandro [Auteur]
Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (EGID) - U1011
Institut Coeur Poumon [CHU Lille]
Echivard, Matthieu [Auteur]
Marquié, Christelle [Auteur]
Institut Coeur Poumon [CHU Lille]
Ortmans, Staniel [Auteur]
Institut Coeur Poumon [CHU Lille]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Drumez, Elodie [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Lemaire, Juliette [Auteur]
Institut Coeur Poumon [CHU Lille]
Cuvillier, Antoine [Auteur]
Institut Coeur Poumon [CHU Lille]
Arnaud, Marine [Auteur]
Institut du Thorax [Nantes]
Potelle, Charlotte [Auteur]
Institut Coeur Poumon [CHU Lille]
Gouraud, Jean-Baptiste [Auteur]
ITX - unité de recherche de l'institut du thorax [ITX]
Andorin, Antoine [Auteur]
ITX - unité de recherche de l'institut du thorax [ITX]
Blangy, Hugues [Auteur]
Sadoul, Nicolas [Auteur]
Probst, Vincent [Auteur]

Klug, Didier [Auteur]
Institut Coeur Poumon [CHU Lille]

Journal title :

Canadian Journal of Cardiology

Abbreviated title :

Can J Cardiol

Publication date :

2020-06-06

ISSN :

1916-7075

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background In this study we aimed to assess long-term outcomes in subcutaneous implantable cardioverter-defibrillator (S-ICD) recipients with structural heart disease by focussing especially on shock incidence, predictors, ...
Show more >Background In this study we aimed to assess long-term outcomes in subcutaneous implantable cardioverter-defibrillator (S-ICD) recipients with structural heart disease by focussing especially on shock incidence, predictors, and associated prognoses. Methods In this multicenter registry‒based study, we retrospectively included all patients who underwent S-ICD implantation at 3 tertiary centers. The prognostic impact of S-ICD shock was assessed with a composite outcome that included all-cause death and hospitalisation for heart failure. Results A total of 351 patients with underlying cardiomyopathy were included in the investigation. Using multivariable Fine and Gray regression models, secondary prevention, left ventricular ejection fraction (LVEF), conditional shock threshold, and QRS duration appeared to be independent predictors of appropriate S-ICD shock occurrence. In the multivariate Cox regression model adjusted for age, baseline LVEF, underlying cardiomyopathy subtype, New York Heart Association class, and appropriate shocks were significantly associated with increased composite prognostic outcome risk (hazard ratio [HR], 2.61; 95% confidence interval [CI], 1.21-5.65; P = 0.014), whereas inappropriate shocks were not (HR, 1.35; 95% CI, 0.75-4.48; P = 0.18). The analysis of each component of the composite prognostic outcome highlighted that the occurrence of appropriate shocks was associated with an increased risk of hospitalisation for heart failure (HR, 3.10; 95% CI, 1.26-7.58; P = 0.013) and a trend for mortality (HR, 2.19; 95% CI, 0.78-6.16; P = 0.14). Conclusions Appropriate S-ICD shocks were associated with a 3-fold increase in acute heart failure admission, whereas inappropriate shocks were not. Conditional shock threshold programming is an independent predictor of S-ICD shock, and its prognostic impact should be investigated further in patients with structural heart disease.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

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

Submission date :

2023-11-15T08:47:05Z
2023-12-12T09:06:52Z