Heart failureRisk Factors for Appropriate Cardioverter-Defibrillator Shocks, Inappropriate Cardioverter-Defibrillator Shocks, and Time to Mortality in 549 Patients With Heart Failure
Section snippets
Methods
We investigated, in an observational, single-center study, the risk factors for appropriate ICD shocks, inappropriate ICD shocks, and interval to all-cause mortality in 434 men and 115 women (mean age 74 years) with heart failure and ICDs. Of the 549 patients, 322 (59%) had ischemic cardiomyopathy and 227 (41%) had nonischemic cardiomyopathy.
The left ventricular ejection fraction was measured from 2-dimensional echocardiograms, as previously described.7 At follow-up every 3 months, the ICD was
Results
Of 549 patients, 163 (30%) had appropriate ICD shocks, 71 (13%) had inappropriate ICD shocks, and 63 (12%) died. Table 1 lists the baseline characteristics of patients with and without inappropriate shocks and the levels of statistical significance. The mean follow-up was 1,243 ± 655 days.
Appropriate ICD shocks occurred in 33 (46%) of 71 patients who had inappropriate ICD shocks and in 130 (27%) of 478 patients who had no inappropriate ICD shocks (p <0.0001). Of the 71 patients with
Discussion
In the present study of 549 patients with heart failure and ICDs, smoking significantly increased the incidence of appropriate ICD shocks 3.7 times, and the use of statins significantly reduced appropriate ICD shocks by 46%. In the MADIT II trial, smoking significantly increased the incidence of appropriate ICD shocks 2.1 times and inappropriate ICD shocks 2.9 times.1 In 209 patients with heart failure and combined cardiac resynchronization-ICD therapy, smoking significantly increased the
References (13)
- et al.
Reduction in ventricular tachyarrhythmias with statins in the Multicenter Automatic Defibrillator Implantation trial (MADIT)-II
J Am Coll Cardiol
(2006) - et al.
Are lipid-lowering drugs also antiarrhythmic drugs?An analysis of the antiarrhythmics versus implantable defibrillators (AVID) trial
J Am Coll Cardiol
(2003) - et al.
Lipid lowering drugs and recurrences of life-threatening ventricular arrhythmias in high-risk patients
J Am Coll Cardiol
(2000) - et al.
Inappropriate implantable cardioverter-defibrillator shocks in MADIT II
J Am Coll Cardiol
(2008) - et al.
Prognosis of congestive heart failure after prior myocardial infarction in older men and women with abnormal versus normal left ventricular ejection fraction
Am J Cardiol
(2000) - et al.
Statin use was associated with reduced mortality in both ischemic and nonischemic cardiomyopathy and in patients with implantable defibrillators: mortality data and mechanistic insights from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT)
Am Heart J
(2007)