Associated factors with the occurrence of inappropriate shocks among admitted patients with ischemic cardiomyopathy

• Published in: ARYA atherosclerosis 2022-10, Vol.18 (October), p.1-7
• Main Authors: Moradi, Maryam, Shahabi, Javad, Vakhshoori, Mehrbod, Shafie, Davood
• Format: Article
• Language: English
• Subjects: appropriate shocks; Body mass index; Cardiac arrhythmia; Cardiomyopathy; Confidence intervals; defibrillators; Diabetes; Ejection fraction; Electrocardiography; Electrolytes; Enzymes; Heart failure; Heart rate; Hypertension; implantable; inappropriate shocks; Ischemia; Laboratories; Males; Medical equipment; Morphology; Mortality; myocardial ischemia; Sinuses; Social sciences
• ISSN: 1735-3955; 2251-6638
• DOI: 10.48305/arya.2022.11742.2372

The presence of sinus tachycardia was 7-38 (95% confidence interval (CI): 1.78-30.56, P= 0.006), which was associated with higher likelihood of inappropriate shock occurrence. [...]patients with atrial fibrillation (AF) had significantly elevated odds of inappropriate shock frequency (odds ratio (OR): 4.32, 95% CI: 1.15-16.13, P= 0.02). Chronic Kidney Disease Introduction Patients suffering from ischemic cardiomyopathy (I CM) are at increased risk of developing ventricular arrhythmias.1 Implantable cardioverter-defibrillators (ICDs) have been announced to be effective for treatment and recommended by both U.S and European guidelines as the first modality to reduce the risk of sudden cardiac death and all-cause mortality in patients with either ischemic or non-ischemic heart failure with more substantial evidence for the former. 2_4 Several underlying factors have been proposed to cause inappropriate shocks among individuals with ICDs, including rapid supraventricular tachycardia, atrial fibrillation (AF) and abnormal sensing5 Previous studies have shown that ICD shocks, regardless of whether shocks are appropriate or inappropriate, are associated with higher mortality risk in the long term.67 Besides, ICD shocks can cause significant psychological effects such as anxiety or depression, which can worsen patients' quality of life.8 It has been reported that approximately one-third of patients would receive a shock from their ICDs within five years of implantation, and 18% of these are categorized as inappropriate ones.9 Therefore, proper management of ICD shocks and maximal effort to prevent ventricular or supraventricular tachyarrhythmia could be essential in managing these patients. ICM was defined as a reduced LVEF associated with at least one of the followings: more than 70% stenosis in one or more of the major epicardial coronary vessels, a history of coronary intervention including angioplasty and/or bypass surgery, stress-induced perfusion abnormalities detected by nuclear scintigraphy indicating myocardial ischemia or a history of transmural myocardial infarction.11 Patients with heart failure caused by myocarditis, primary valvular disease, restrictive or hypertrophic cardiomyopathies and other non-ischemic cardiomyopathies were excluded from our study. In terms of inappropriate shock incidence, device alteration, including complete device analysis and morphology template assessment, and device parameter alteration for ventricular tachycardia (VT) o