Implantable cardioverter defibrillator shocks from ventricular tachyarrhythmias in patients with ischemic heart disease: preventative measures, shortcomings, cost‐effectiveness and global practice perspectives

2021 ◽  
Author(s):  
Bharat K. Kantharia
Keyword(s):  
Heart Disease ◽  
Cost Effectiveness ◽  
Ischemic Heart Disease ◽  
Implantable Cardioverter Defibrillator ◽  
Ischemic Heart ◽  
Ventricular Tachyarrhythmias ◽  
Cardioverter Defibrillator ◽  
Preventative Measures

scholarly journals PREDICTION OF NON-BENEFIT FROM IMPLANTABLE CARDIOVERTER DEFIBRILLATOR TREATMENT IN PRIMARY PREVENTION PATIENTS WITH ISCHEMIC HEART DISEASE

2011 ◽  
Vol 57 (14) ◽  
pp. E140
Author(s):  
Johannes B. Van Rees ◽  
C. Jan Willem Borleffs ◽  
Guido H. van Welsenes ◽  
Enno T. van der Velde ◽  
Lieselot van Erven ◽  
...  
Keyword(s):  
Heart Disease ◽  
Primary Prevention ◽  
Ischemic Heart Disease ◽  
Implantable Cardioverter Defibrillator ◽  
Ischemic Heart ◽  
Cardioverter Defibrillator

Abstract 16496: Longitudinal Outcomes After Implantation of a Subcutaneous or Transvenous Implantable Cardioverter Defibrillator in Older Patients: A Report From the National Cardiovascular Data Registry

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Daniel J Friedman ◽  
Craig Parzynski ◽  
E. Kevin Heist ◽  
Andrea M Russo ◽  
Isuru Ranasinghe ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Implantable Cardioverter Defibrillator ◽  
Older Patients ◽  
Cox Regression ◽  
Ischemic Heart ◽  
Cardioverter Defibrillator ◽  
Data Registry ◽  
All Cause Mortality ◽  
National Cardiovascular

Introduction: The subcutaneous (S-) implantable cardioverter defibrillator (ICD) is an alternative to the transvenous (TV-) ICD that is increasingly implanted in younger patients. However, data on the safety and effectiveness of the S-ICD in older patients are lacking. Methods: We compared S-ICD and single chamber TV-ICD implants in Medicare beneficiaries (≥65yrs) using National Cardiovascular Data Registry ICD Registry data from 9/28/2012 through 12/31/2017. We excluded patients with prior pacemaker or ICD, an indication for pacing or resynchronization, and those undergoing implant in an acute setting. Mortality status was determined using the Medicare master summary beneficiary file. Cox regression analyses with overlap weights were used to compare all-cause mortality. Mean cumulative counts of all-cause readmissions were compared among for Fee for Service beneficiaries. Results: A total of 23,717 patients met inclusion criteria [mean age 72.7±5.8 years, 29% female, 69% ischemic heart disease, 33% atrial arrhythmias, 49% NYHA II, 31.7% NYHA III, ejection fraction (EF) 28±9%, 3% dialysis dependent, 20% with prior ventricular tachycardia]. Compared to TV-ICD patients (n=22,264), S-ICD patients (n=1,453, 6% overall) were more often male, black, diabetic, dialysis dependent and were less likely to have atrial or ventricular arrhythmias or ischemic heart disease. There was no difference in age or EF between the 2 groups. In adjusted analyses, during a median follow-up of 2.3 years (IQR: 1.2 - 3.5), there was no difference between the 2 groups in all-cause mortality (HR 1.04, CI 0.91-1.17, Figure A ) or readmissions (based on overlap of confidence intervals, Figure B ). Conclusions: In a large representative cohort of older patients undergoing ICD implant, all-cause mortality and readmission were similar among S-ICD and TV-ICD recipients. These findings support use of the S-ICD for the prevention of sudden cardiac death in appropriately selected older patients.

scholarly journals Mortality, appropriate and inappropriate shocks - observations from an institutional implantable cardioverter defibrillator registry

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
I Prepolec ◽  
V Pasara ◽  
E Ciglenecki ◽  
JE Bogdanic ◽  
J Putric Posavec ◽  
...  
Keyword(s):  
Heart Disease ◽  
Secondary Prevention ◽  
Ischemic Heart Disease ◽  
Ischaemic Heart Disease ◽  
Implantable Cardioverter Defibrillator ◽  
Ischemic Heart ◽  
Cardioverter Defibrillator ◽  
Inappropriate Shocks ◽  
Device Infection

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Implantable cardioverter defibrillator (ICD) is an effective therapy for primary (PP) and secondary prevention (SP) of sudden cardiac death (SCD). ICD adverse events include inappropriate shocks (IS), device infection and failure.  Methods We analysed the data concerning all newly implanted ICDs in our institution from 2011 to 2017. Follow-up data was collected until the end of 2019. Results In total, 507 ICDs were implanted (85.4% male, 57.6 ± 14.0 years-old), 375 (74.0%) for PP and 132 (26.0%) for SP. The mean follow-up was 34.3 ± 23.8 months. ICD delivered therapy in 42.4% of SP and in 28.8% of PP patients (p = 0.15). In PP, shocks were delivered in 25.7% of non-ischaemic heart disease (NIHD) and in 17.6% ischaemic heart disease (IHD) patients (p = 0.81). IS were significantly more common in NIHD patients (13.8% vs 2.4% in IHD group, p < 0.0001). PP patients with NIHD also had a higher shock burden (average of 8.0 ± 17.4 shocks compared to 2.7 ± 3.0 in the IHD group). However, it failed to reach the level of statistical significance (p = 0.052). In SP, the rate of ICD activation and that of IS were similar in both groups (IHD and NIHD). In total, 32.6% of SP patients received appropriate shock (AS) and 5.3% of them received at least one IS (average number of AS and IS being 8.7 ± 11.5 and 1.1 ± 0.4 respectively). Mortality was significantly higher in SP than in PP (34.8% vs 13.9%, p < 0.001). In PP, significantly more deaths occurred among IHD than NIHD patients (18.8% vs 10.0%, p < 0.001).  Conclusion The prevalence of AS and IS was relatively higher than reported elsewhere. Same was true for mortality. Interestingly, the rate of IS was somewhat higher in NIHD than in IHD, which was unexpected. ICD outcomes Primary prevention Secondary prevention Total IHD NIHD Total IHD NIHD Patients, n 375 165 210 132 88 44 Patients with ICD activation, n (%) 108 (28.8) 46 (27.9) 62 (29.5) 56 (42.4) 33 (37.5) 22 (50.0) Patientns with AS, n (%) 60 (16.0) 27 (16.4) 33 (15.7) 43 (32.6) 29 (33.0) 14 (31.8) Patientns with IS, n (%) 33 (8.8) 4 (2.4) 29 (13.8) 7 (5.3) 5 (5.7) 2 (4.5) AS delivered (mean ± SD) 5.6 ± 13.3 2.7 ± 3.0 8.0 ± 17.4 8.7 ± 11.5 9.9 ± 12.2 9.7 ± 17.6 IS delivered (mean ± SD) 3.2 ± 5.1 1.2 ± 0.5 3.5 ± 5.4 1.1 ± 0.4 1.0 ± 0 3.2 ± 5.2 Deaths, n (%) 52 (13.9) 31 (18.8) 21 (10.0) 46 (34.8) 32 (36.4) 14 (31.8) Time to death (months, mean ± SD) 20.3 ± 13.9 19.9 ± 12.6 21.1 ± 16.5 27.1 ± 25.7 28.9 ± 24.9 22.6 ± 28.1 ICD, implantable cardioverter defibrillator; IHD, ischemic heart disease; NIHD, non-ischemic heart disease; AS, appropriate shock; IS, inappropriate shock

Outcomes of Implantable Cardioverter Defibrillator in Patients with Ischemic Versus Non-Ischemic Heart Disease

2006 ◽  
Vol 12 (6) ◽  
pp. S60
Author(s):  
Anuj R. Shah ◽  
Haris Athar ◽  
Arnoldas Giedrimas ◽  
Danette Guertin ◽  
Dalia Giedrimiene ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Implantable Cardioverter Defibrillator ◽  
Ischemic Heart ◽  
Cardioverter Defibrillator

Cost-effectiveness of preoperative positron emission tomography in ischemic heart disease

2002 ◽  
Vol 73 (5) ◽  
pp. 1403-1409 ◽  
Author(s):  
Paul B Jacklin ◽  
Sally F Barrington ◽  
James C Roxburgh ◽  
Graham Jackson ◽  
Dimitrios Sariklis ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Heart Disease ◽  
Cost Effectiveness ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
Emission Tomography ◽  
Positron Emission
Sign in / Sign up

Export Citation Format

Share Document