; Willems, Rik
; Sprenkeler, David J. ; Fischer, Thomas H. ; Flevari, Panayota ; Hasenfuß, Gerd ; Katsaras, Dimitrios ; Kirova, Aleksandra ; Lehnart, Stephan E. ; Lüthje, Lars ; Röver, Christian ; Seegers, Joachim ; Sossalla, Samuel ; Dunnink, Albert ; Sritharan, Rajevaa ; Tuinenburg, Anton E. ; Vandenberk, Bert ; Vos, Marc A. ; Wijers, Sofieke C. ; Friede, Tim
; Zabel, Markus | Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | International Journal of Cardiology | ||||
| Publisher: | ELSEVIER IRELAND LTD | ||||
| Place of Publication: | CLARE | ||||
| Volume: | 272 | ||||
| Page Range: | pp. 102-107 | ||||
| Date: | 2018 | ||||
| Institutions: | Medicine > Lehrstuhl für Innere Medizin II | ||||
| Identification Number: |
| ||||
| Keywords: | IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR; SUDDEN CARDIAC DEATH; T-WAVE ALTERNANS; PROGRAMMED VENTRICULAR STIMULATION; CORONARY-ARTERY-DISEASE; HEART-FAILURE; MYOCARDIAL-INFARCTION; PRIMARY PREVENTION; ISCHEMIC CARDIOMYOPATHY; CLINICAL-PRACTICE; Implantable cardioverter defibrillator; Risk factors; Mortality; Sudden cardiac death | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 46543 |
Abstract
Background and objective: We prospectively investigated combinations of risk stratifiers including multiple EP diagnostics in a cohort study of ICD patients. Methods: For 672 enrolled patients, we collected history, LVEF, EP study and T-wave altemans testing, 24-h Hotter, IsiT-proBNP, and the eGFR All-cause mortality and first appropriate ICD shock were predefined endpoints. Results: The 635 ...

Abstract
Background and objective: We prospectively investigated combinations of risk stratifiers including multiple EP diagnostics in a cohort study of ICD patients. Methods: For 672 enrolled patients, we collected history, LVEF, EP study and T-wave altemans testing, 24-h Hotter, IsiT-proBNP, and the eGFR All-cause mortality and first appropriate ICD shock were predefined endpoints. Results: The 635 patients included in the final analyses were 63 +/- 13 years old, 81% were male, LVEF averaged 40 +/- 14%. 20% were inducible at EP study, 63% had a primary prophylactic ICD. During follow-up over 4.3 +/- 15 years, 108 patients died (4.0% per year), and appropriate shock therapy occurred inn - 96 (3.9% per year). In multivariate regression, age (p < 0.001), LVEF (p < 0.001), NYHA functional class (p = 0.007), eGFR (p = 0.024), a history of atrial fibrillation (p = 0.011). and NT-pro-BNP (p = 0.002) were predictors of mortality. LVEF (p = 0.002), inducibility at EP study (p = 0.007). and secondary prophylaxis (p = 0.002) were identified as independent predictors of appropriate shocks. A high annualized risk of shocks of about 10% per year was prevalent in the upper quintile of the shock score. In contrast, a low annual risk of shocks (1.8% per year) was found in the lower two quintiles of the shock score. The lower two quintiles of the mortality score featured an annual mortality <0.6%. Conclusions: In a prospective ICD patient cohort, a very good approximation of mortality versus arrhythmic risk was possible using a multivariable diagnostic strategy. EP stimulation is the best test to assess risk of arrhythmias resulting in ICD shocks. (C) 2018 The Authors. Published by Elsevier B.V.
Metadata last modified: 28 Jul 2021 16:54
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