scholarly journals The role of variability in night-time mean heart rate on the prediction of ventricular arrhythmias and all-cause mortality in implantable cardioverter defibrillator patients

EP Europace ◽  
2015 ◽  
Vol 17 (suppl 2) ◽  
pp. ii76-ii82 ◽  
Author(s):  
Shuang Zhao ◽  
Keping Chen ◽  
Yangang Su ◽  
Wei Hua ◽  
Jielin Pu ◽  
...  
Keyword(s):  
Heart Rate ◽  
Implantable Cardioverter Defibrillator ◽  
Ventricular Arrhythmias ◽  
Night Time ◽  
Cardioverter Defibrillator ◽  
All Cause Mortality ◽  
Mean Heart Rate

scholarly journals Arrhythmic Sudden Cardiac Death and the Role of Implantable Cardioverter-Defibrillator in Patients with Cardiac Amyloidosis—A Narrative Literature Review

2021 ◽  
Vol 10 (9) ◽  
pp. 1858
Author(s):  
Aleksandra Liżewska-Springer ◽  
Grzegorz Sławiński ◽  
Ewa Lewicka
Keyword(s):  
Sudden Cardiac Death ◽  
Implantable Cardioverter Defibrillator ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Cardiac Amyloidosis ◽  
Cardioverter Defibrillator ◽  
Increased Risk ◽  
Narrative Literature ◽  
Narrative Literature Review

Cardiac amyloidosis (CA) is considered to be associated with an increased risk of sudden cardiac death (SCD) due to ventricular tachyarrhythmias and electromechanical dissociation. However, current arrhythmic risk stratification and the role of an implantable cardioverter-defibrillator (ICD) for primary prevention of SCD remains unclear. This article provides a narrative review of the literature on electrophysiological abnormalities in the context of ventricular arrhythmias in patients with CA and the role of ICD in terms of survival benefit in this group of patients.

scholarly journals Association of Night-Time Heart Rate With Ventricular Tachyarrhythmias, Appropriate and Inappropriate Implantable Cardioverter-Defibrillator Shocks

2021 ◽  
Vol 8 ◽  
Author(s):  
Xuerong Sun ◽  
Bin Zhou ◽  
Keping Chen ◽  
Wei Hua ◽  
Yangang Su ◽  
...  
Keyword(s):  
Heart Rate ◽  
Implantable Cardioverter Defibrillator ◽  
Home Monitoring ◽  
Smooth Curve ◽  
Cardiac Resynchronization ◽  
Ventricular Tachyarrhythmias ◽  
Night Time ◽  
Predictive Values ◽  
Cardioverter Defibrillator ◽  
Non Linear

Background: Night-time heart rate (HR) is expected to reflect more accurately the cardiac autonomic function of modulating cardiovascular activity. Few studies have been conducted on the predictive values of night-time HR in relation to cardioverter-defibrillator therapies.Aims: To explore the associations of night-time HR with the ventricular tachyarrhythmias (VTAs), appropriate and inappropriate implantable cardioverter-defibrillator (ICD) shocks.Methods: Patients from the SUMMIT registry receiving ICD or cardiac resynchronization therapy with defibrillator (CRT-D) implantation were retrospectively analyzed using archived home monitoring data. Night-time HR was recorded from 2:00 am to 6:00 am during the first 30 to 60 days after implantation. VTA events and ICD shocks were identified using the intracardiac electrograms by two independent physicians. Restricted cubic splines and smooth curve fitting were conducted to address the non-linear associations between night-time HR and adjusted hazards for clinical outcomes.Results: Over a mean follow-up duration of 55.8 ± 22.7 months, 187 deaths were observed among 730 patients. VTAs, appropriate and inappropriate ICD shocks were observed in 422 (57.8%), 293 (40.1%), and 72 (10.0%) patients, respectively. Apparent U-shaped non-linear associations of night-time HR with VTAs (P for non-linearity = 0.007), appropriate ICD shocks (P for non-linearity = 0.003) and inappropriate ICD shocks (P for non-linearity = 0.014) were detected. When night-time HR was beyond 60 bpm, every 1 bpm increase in night-time HR could result in 3.2, 3.3, and 4.9% higher risks of VTAs and appropriate and inappropriate ICD shocks, respectively; when night-time HR was lower than 60 bpm, every 1 bpm increase in night-time HR could result in 6.0 and 10.7% lower risks of appropriate and inappropriate ICD shocks. Compared to night-time HR of ≤ 50 or ≥70 bpm, night-time HR of 50–70 bpm was associated with 24.9, 30.2, 63.5, and 31.5% reduced incidences of VTA events, appropriate ICD shocks, inappropriate ICD shocks, and all-cause mortality, respectively.Conclusion: Apparent non-linear associations of night-time HR with VTAs and ICD shocks were detected. An increasing incidence of VTAs and ICD shocks was observed at both low and high levels of night-time HR. Night-time HR of 50–70 bpm might be the optimal therapeutics target for the management of ICD/CRT-D recipients.

scholarly journals Ongoing Risk of Ventricular Arrhythmias and All-cause Mortality at Implantable Cardioverter Defibrillator Generator Change: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Matthew F. Yuyun ◽  
Sebhat A. Erqou ◽  
Adelqui O. Peralta ◽  
Peter S. Hoffmeister ◽  
Hirad Yarmohammadi ◽  
...  
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Ventricular Arrhythmias ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cochrane Library ◽  
Ventricular Ejection Fraction ◽  
Cardioverter Defibrillator ◽  
All Cause Mortality ◽  
Meta Analyses

Background - Uncertainty still surrounds implantable cardioverter defibrillator (ICD) generator change at time of elective replacement indicator (ERI), in primary prevention patients with improved left ventricular ejection fraction (LVEF) beyond guideline recommendations or without prior appropriate ICD therapies. Methods - We conducted a meta-analysis of studies assessing the risk of appropriate ICD therapies and all-cause mortality after generator change in patients with improved LVEF > 35% versus unimproved LVEF ≤ 35% or patients without versus with prior appropriate ICD therapies during the life of their first ICD generator. A systematic electronic search of PubMed, EMBASE, and Cochrane Library databases until December 31 st , 2019 was performed. Estimates were combined using random-effects model meta-analyses. Results - In 15 studies that included 29730 patients, 25.3% had LVEF improvement >35% at time of generator change. The pooled annual incidence of appropriate ICD therapies was significantly lower in those with improved LVEF, compared to patients with unimproved LVEF: 4.6% versus 10.7%; risk ratio (RR) 0.50 (95% CI 0.36-0.68), p <0.0001. The pooled rate of all-cause mortality was 6.6% versus 10.9% per year, RR of 0.65 (95% CI 0.62-0.69), p < 0.0001. Risk of inappropriate shock was comparable between the two groups (p = 0.750). In 8 studies (N = 27209), the pooled incidence of ventricular arrhythmia (VA) was significantly lower in patients without prior ICD therapies (3.9% per annum), compared to those with prior ICD therapies (12.5 % per annum), RR of 0.37 (95% CI 0.33-0.41), P<0.001. Conclusions - There was significant reduction in risk of ventricular arrhythmias and mortality in patients with improved versus unimproved LVEF or those who received versus those who did not receive appropriate ICD therapies during the life of their first ICD generator. However, we found a substantial residual outcome risk in these groups of patients.

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