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Efficacy and safety of implantable cardiac defibrillators for treatment of ventricular arrhythmias in patients with cardiac sarcoidosis.
- Source :
-
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2013 Mar; Vol. 15 (3), pp. 347-54. Date of Electronic Publication: 2012 Sep 21. - Publication Year :
- 2013
-
Abstract
- Aims: Implantable cardiac defibrillator (ICD) implantation is a class IIA recommendation for patients with cardiac sarcoidosis (CS). However, little is known about the efficacy and safety of ICDs in this population. The goal of this multicentre retrospective data review was to evaluate the efficacy and safety of ICDs in patients with CS.<br />Methods and Results: Electrophysiologists at academic medical centres were asked to identify consecutive patients with CS and an ICD. Clinical information, ICD therapy history, and device complications were collected for each patient. Data were collected on 235 patients from 13 institutions, 64.7% male with mean age 55.6 ± 11.1. Over a mean follow-up of 4.2 ± 4.0 years, 85 of 234 (36.2%) patients received an appropriate ICD therapy (shocks and/or anti-tachycardia pacing) and 67 of 226 (29.7%) received an appropriate shock. Fifty-seven of 235 patients (24.3%) received a total of 222 inappropriate shocks. Forty-six adverse events occurred in 41 of 235 patients (17.4%). Patients who received appropriate ICD therapies were more likely to be male (73.8 vs. 59.6%, P = 0.0330), have a history of syncope (40.5 vs. 22.5%, P = 0.0044), lower left ventricular ejection fraction (38.1 ± 15.2 vs. 48.8 ± 14.7%, P ≤ 0.0001), ventricular pacing on baseline electrocardiogram (16.1 vs. 2.1%, P = 0.0002), and a secondary prevention indication (60.7 vs. 24.5%, P < 0.0001) compared with those who did not receive appropriate ICD therapies.<br />Conclusion: Patients with CS and ICDs are at high risk for ventricular arrhythmias. This population also has high rates of inappropriate shocks and device complications.
- Subjects :
- Adult
Aged
Aged, 80 and over
Canada
Cardiomyopathies diagnosis
Cardiomyopathies mortality
Cardiomyopathies physiopathology
Death, Sudden, Cardiac etiology
Death, Sudden, Cardiac prevention & control
Electric Countershock adverse effects
Electric Countershock mortality
Equipment Design
Equipment Failure
Female
Humans
India
Male
Middle Aged
Primary Prevention methods
Retrospective Studies
Risk Assessment
Risk Factors
Sarcoidosis diagnosis
Sarcoidosis mortality
Sarcoidosis physiopathology
Secondary Prevention methods
Tachycardia, Ventricular diagnosis
Tachycardia, Ventricular etiology
Tachycardia, Ventricular mortality
Tachycardia, Ventricular physiopathology
Time Factors
Treatment Outcome
United States
Ventricular Fibrillation diagnosis
Ventricular Fibrillation etiology
Ventricular Fibrillation mortality
Ventricular Fibrillation physiopathology
Young Adult
Cardiomyopathies complications
Defibrillators, Implantable
Electric Countershock instrumentation
Primary Prevention instrumentation
Sarcoidosis complications
Secondary Prevention instrumentation
Tachycardia, Ventricular therapy
Ventricular Fibrillation therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2092
- Volume :
- 15
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 23002195
- Full Text :
- https://doi.org/10.1093/europace/eus316