P1530 False negative detections of ventricular arrhythmias in implantable cardioverter-defibrillator

Dilated cardiomyopathy (DCM) is a disease characterised as left ventricular (LV) or biventricular dilatation with impaired systolic function. Regardless of underlying cause patients with DCM have a propensity to ventricular arrhythmias and sudden cardiac death. Implantable Cardioverter Defibrillator (ICD) implantation for these patients results in significant reduction of sudden cardiac death [1-3]. ICD devices may be limited by right ventricle (RV) sensing dysfunction with low RV sensing amplitude. We present a clinical case of patient with DCM, implanted ICD and low R wave sensing on RV lead.

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Incidence of Ventricular Arrhythmias and 1‐Year Predictors of Mortality in Patients Treated With Implantable Cardioverter‐Defibrillator Undergoing Generator Replacement

Journal of the American Heart Association ◽

10.1161/jaha.120.018090 ◽

2021 ◽

Vol 10 (4) ◽

Author(s):

Andrea Demarchi ◽

Stefano Cornara ◽

Antonio Sanzo ◽

Simone Savastano ◽

Barbara Petracci ◽

...

Keyword(s):

Atrial Fibrillation ◽

Heart Disease ◽

Implantable Cardioverter Defibrillator ◽

Ventricular Arrhythmias ◽

Multivariable Analysis ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Cardioverter Defibrillator ◽

Generator Replacement

Background When implantable cardioverter defibrillator (ICD) battery is depleted most patients undergo generator replacement (GR) even in the absence of persistent ICD indication. The aim of this study was to assess the incidence of ventricular arrhythmias and the overall prognosis of patients with and without persistent ICD indication undergoing GR. Predictors of 1‐year mortality were also analyzed. Methods and Results Patients with structural heart disease implanted with primary prevention ICD undergoing GR were included. Patients were stratified based on the presence/absence of persistent ICD indication (left ventricular ejection fraction ≤35% at the time of GR and/or history of appropriate ICD therapies during the first generator's life). The study included 371 patients (82% male, 40% with ischemic heart disease). One third of patients (n=121) no longer met ICD indication at the time of GR. During a median follow‐up of 34 months after GR patients without persistent ICD indication showed a significantly lower incidence of appropriate ICD shocks (1.9% versus 16.2%, P <0.001) and ICD therapies. 1‐year mortality was also significantly lower in patients without persistent ICD indication (1% versus 8.3%, P =0.009). At multivariable analysis permanent atrial fibrillation, chronic advanced renal impairment, age >80, and persistent ICD indication were found to be significant predictors of 1‐year mortality. Conclusions Patients without persistent ICD indication at the time of GR show a low incidence of appropriate ICD therapies after GR. Persistent ICD indication, atrial fibrillation, advanced chronic renal disease, and age >80 are significant predictors of 1‐year mortality. Our findings enlighten the need of performing a comprehensive clinical reevaluation of ICD patients at the time of GR.

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Evaluation of a Dual Chamber Implantable Cardioverter Defibrillator for the Treatment of Atrial and Ventricular Arrhythmias

Pacing and Clinical Electrophysiology ◽

10.1046/j.1460-9592.2003.00072.x ◽

2003 ◽

Vol 26 (1p2) ◽

pp. 461-465 ◽

Cited By ~ 11

Author(s):

GIUSEPPE BORIANI ◽

CHRISTIAN WOLLMANN ◽

MAURO BIFFI ◽

MARTIN KUHL ◽

ANDREAS SCHUCHERT ◽

...

Keyword(s):

Implantable Cardioverter Defibrillator ◽

Ventricular Arrhythmias ◽

Dual Chamber ◽

Cardioverter Defibrillator ◽

Chamber Implantable ◽

Dual Chamber Implantable

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Anger and long-term mortality and ventricular arrhythmias in patients with a first-time implantable cardioverter-defibrillator: data from the MIDAS study

EP Europace ◽

10.1093/europace/euaa083 ◽

2020 ◽

Vol 22 (7) ◽

pp. 1054-1061 ◽

Cited By ~ 2

Author(s):

Susanne S Pedersen ◽

Christina Maar Andersen ◽

Matthew Burg ◽

Dominic A M J Theuns

Keyword(s):

Implantable Cardioverter Defibrillator ◽

Mortality Risk ◽

Ventricular Arrhythmias ◽

Self Regulation ◽

The State ◽

Trait Anger ◽

Cardioverter Defibrillator ◽

State Anger ◽

First Time

Abstract Aims Psychosocial factors increase risk for incident heart disease and poor prognosis. In patients with an implantable cardioverter-defibrillator (ICD), negative emotions have been associated with increased mortality risk, although the association with ventricular arrhythmias (VAs) is less consistent. Anger has been linked to incident ICD shocks, but no prospective study has examined the association of anger (state and trait) with mortality or VAs in the ICD population. In a consecutively recruited cohort of first-time ICD patients, we examined the association of state and trait anger with 7-year mortality risk and time to first VA. Methods and results A consecutive cohort of patients implanted with a first-time ICD (n = 388; 80% men) between 2003 and 2010 completed the State-Trait Anger Scale and were followed for 7 years. Outcomes were mortality and time to first appropriate ICD therapy. State anger at the time of implant was associated with increased mortality risk in adjusted analyses, with a 1-point increase in score on the state anger measures associated with a 5% [hazard ratio 1.05; 95% confidence interval 1.01–1.09; P = 0.015] increased 7-year mortality risk. We found no statistically significant differences in mortality risk for trait anger, nor an effect for state or trait anger on time to first treated VA (all ps > 0.05). Conclusion This is the first study to examine the association of state and trait anger with long-term clinical outcomes in ICD patients. Evaluating anger reduction strategies in newly implanted ICD patients, such as self-regulation or mindfulness techniques, may be warranted for reducing mortality risk.

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