Impact of atrial fibrillation/flutter on outcomes of patients with implantable cardioverter defibrillators: A sub-analysis of the Nippon Storm study

•This is a sub-analysis from the NIPPON storm study, a multicenter cohort study in Japan.•Atrial fibrillation/flutter (AF) is an independent risk factor for all-cause death and inappropriate implantable cardioverter-defibrillator therapy.•Incidence of sudden death and arrhythmic death is higher in p...

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Published in:Journal of cardiology 2021-09, Vol.78 (3), p.244-249
Main Authors: Maruyama, Masahiro, Yasuoka, Ryobun, Nagano, Tomoya, Nakazawa, Gaku, Noda, Takashi, Nitta, Takashi, Aizawa, Yoshifusa, Ohe, Tohru, Kurita, Takashi
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Language:English
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Atrial fibrillation
Implantable cardioverter
Inappropriate therapy
Mortality
Nippon Storm study
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cited_by cdi_FETCH-LOGICAL-c508t-c823cfbedbf3327cb8ed358e44e841d930305c3422cff6c588421f458953bb083
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creator Maruyama, Masahiro
Yasuoka, Ryobun
Nagano, Tomoya
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Aizawa, Yoshifusa
Ohe, Tohru
Kurita, Takashi
description •This is a sub-analysis from the NIPPON storm study, a multicenter cohort study in Japan.•Atrial fibrillation/flutter (AF) is an independent risk factor for all-cause death and inappropriate implantable cardioverter-defibrillator therapy.•Incidence of sudden death and arrhythmic death is higher in patients with AF. Implantable cardioverter-defibrillator and cardiac resynchronization therapy using a defibrillator (ICD/CRT-D) are established means of reducing mortality due to ventricular arrhythmia. Although atrial fibrillation/flutter (AF) is the most common cardiac arrhythmia in patients with heart disease, the impact of AF on the prognosis of patients with ICD/CRT-D remains controversial. We analyzed data from the Nippon Storm Study, a prospective observational study of 1570 patients that was conducted at 48 Japanese ICD centers. We allocated 1549 participants to AF and non-AF groups, compared their clinical data at the time of enrollment, and monitored the incidences of mortality, hospitalization, and appropriate and inappropriate ICD/CRT-D therapy during a median 28 months. When the AF (n = 257, 16.6%) and non-AF-(n = 1292, 83.4%) groups were compared, the AF group was older (67.7 vs. 61.4 years; p
doi_str_mv 10.1016/j.jjcc.2021.04.003
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Implantable cardioverter-defibrillator and cardiac resynchronization therapy using a defibrillator (ICD/CRT-D) are established means of reducing mortality due to ventricular arrhythmia. Although atrial fibrillation/flutter (AF) is the most common cardiac arrhythmia in patients with heart disease, the impact of AF on the prognosis of patients with ICD/CRT-D remains controversial. We analyzed data from the Nippon Storm Study, a prospective observational study of 1570 patients that was conducted at 48 Japanese ICD centers. We allocated 1549 participants to AF and non-AF groups, compared their clinical data at the time of enrollment, and monitored the incidences of mortality, hospitalization, and appropriate and inappropriate ICD/CRT-D therapy during a median 28 months. When the AF (n = 257, 16.6%) and non-AF-(n = 1292, 83.4%) groups were compared, the AF group was older (67.7 vs. 61.4 years; p&lt;0.0001), and had lower left ventricular ejection fraction (38.0 ± 17.0% vs. 43.5 ± 18.9%; p&lt;0.0001). During follow up, mortality was significantly higher in the AF than the non-AF group (p&lt;0.0001). In multivariate analysis, AF was significantly associated with all-cause mortality [p = 0.013; hazard ratio (HR)=1.62]. Inappropriate ICD/CRT-D therapy occurred in 40/257 patients (15.6%) and AF was associated with a higher prevalence of inappropriate ICD/CRT-D therapy (p&lt;0.0001; HR=2.25). 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Implantable cardioverter-defibrillator and cardiac resynchronization therapy using a defibrillator (ICD/CRT-D) are established means of reducing mortality due to ventricular arrhythmia. Although atrial fibrillation/flutter (AF) is the most common cardiac arrhythmia in patients with heart disease, the impact of AF on the prognosis of patients with ICD/CRT-D remains controversial. We analyzed data from the Nippon Storm Study, a prospective observational study of 1570 patients that was conducted at 48 Japanese ICD centers. We allocated 1549 participants to AF and non-AF groups, compared their clinical data at the time of enrollment, and monitored the incidences of mortality, hospitalization, and appropriate and inappropriate ICD/CRT-D therapy during a median 28 months. When the AF (n = 257, 16.6%) and non-AF-(n = 1292, 83.4%) groups were compared, the AF group was older (67.7 vs. 61.4 years; p&lt;0.0001), and had lower left ventricular ejection fraction (38.0 ± 17.0% vs. 43.5 ± 18.9%; p&lt;0.0001). During follow up, mortality was significantly higher in the AF than the non-AF group (p&lt;0.0001). In multivariate analysis, AF was significantly associated with all-cause mortality [p = 0.013; hazard ratio (HR)=1.62]. Inappropriate ICD/CRT-D therapy occurred in 40/257 patients (15.6%) and AF was associated with a higher prevalence of inappropriate ICD/CRT-D therapy (p&lt;0.0001; HR=2.25). 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subjects Atrial fibrillation
Implantable cardioverter
Inappropriate therapy
Mortality
Nippon Storm study
title Impact of atrial fibrillation/flutter on outcomes of patients with implantable cardioverter defibrillators: A sub-analysis of the Nippon Storm study
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