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Appropriate Therapy But Not Inappropriate Shocks Predict Survival in Implantable Cardioverter Defibrillator Patients
Background: Inappropriate implantable cardioverter defibrillator (ICD) shocks have been linked to a worse clinical outcome due to direct myocardial injury. Hypothesis: The occurrence of ventricular tachyarrhythmia indicating progression of the underlying heart disease, but not the ICD shock itself,...
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| Published in: | Clinical cardiology (Mahwah, N.J.) N.J.), 2011-07, Vol.34 (7), p.433-436 |
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| container_issue | 7 |
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| container_title | Clinical cardiology (Mahwah, N.J.) |
| container_volume | 34 |
| creator | Dichtl, Wolfgang Wolber, Thomas Paoli, Ursula Brüllmann, Simon Stühlinger, Markus Berger, Thomas Spuller, Karin Strasak, Alexander Pachinger, Otmar Haegeli, Laurent M. Duru, Firat Hintringer, Florian |
| description | Background:
Inappropriate implantable cardioverter defibrillator (ICD) shocks have been linked to a worse clinical outcome due to direct myocardial injury.
Hypothesis:
The occurrence of ventricular tachyarrhythmia indicating progression of the underlying heart disease, but not the ICD shock itself, has prognostic impact in clinical routine.
Methods:
In a retrospective study, 1117 recipients of an ICD were analyzed with respect to appropriate and inappropriate therapies and survival.
Results:
During a mean follow‐up of 2.92 years, appropriate therapy occurred in 27.7% and 54.0% of patients who had received an ICD for primary and secondary prevention of sudden cardiac death (SCD), respectively (P |
| doi_str_mv | 10.1002/clc.20910 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6652665</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3278023731</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4720-1c43b3d7a9334987ef3f8c2ad3630b53310c6bae7d0b7c3205bc2607fe8e470a3</originalsourceid><addsrcrecordid>eNp1kUtv1DAUhS0EosPAgj-ALCGEWKT1I7GTDVIJr5FGUKllbd04DuPiiYPtDJp_j8sMpSCxsLy4n8655x6EnlJySglhZ9rpU0YaSu6hBW04K2rJ5X20IFSQomF1c4IexXidUVIz_hCdMCpkXVblAqXzaQp-ChaSwVcbE2Da4zdzwp98wqsR7kwvN15_i_gimN7qhC_nsLM7cNiOeLWdHIwJOmdwC6G3fmdCMgG_NYPtgnUOkg_4ApI1Y4qP0YMBXDRPjv8SfXn_7qr9WKw_f1i15-tCl5KRguqSd7yX0HBeNrU0Ax9qzaDngpOu4pwSLTowsied1JyRqtNMEDmY2pSSAF-i1wfdae62ptfZO4BTOc8Wwl55sOrvyWg36qvfKSEqll8WeHkUCP77bGJSWxu1yXFG4-eoainL3EA-6hI9_4e89nMYczpFKyrzvQURmXp1oHTwMQYz3O5CibqpUuUq1a8qM_vs7vK35O_uMvDiCEDU4IYAo7bxD1fyRpTiZrWzA_fDOrP_v6Nq1-3B-ifvh7cZ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1517167606</pqid></control><display><type>article</type><title>Appropriate Therapy But Not Inappropriate Shocks Predict Survival in Implantable Cardioverter Defibrillator Patients</title><source>PubMed Central</source><creator>Dichtl, Wolfgang ; Wolber, Thomas ; Paoli, Ursula ; Brüllmann, Simon ; Stühlinger, Markus ; Berger, Thomas ; Spuller, Karin ; Strasak, Alexander ; Pachinger, Otmar ; Haegeli, Laurent M. ; Duru, Firat ; Hintringer, Florian</creator><creatorcontrib>Dichtl, Wolfgang ; Wolber, Thomas ; Paoli, Ursula ; Brüllmann, Simon ; Stühlinger, Markus ; Berger, Thomas ; Spuller, Karin ; Strasak, Alexander ; Pachinger, Otmar ; Haegeli, Laurent M. ; Duru, Firat ; Hintringer, Florian</creatorcontrib><description>Background:
Inappropriate implantable cardioverter defibrillator (ICD) shocks have been linked to a worse clinical outcome due to direct myocardial injury.
Hypothesis:
The occurrence of ventricular tachyarrhythmia indicating progression of the underlying heart disease, but not the ICD shock itself, has prognostic impact in clinical routine.
Methods:
In a retrospective study, 1117 recipients of an ICD were analyzed with respect to appropriate and inappropriate therapies and survival.
Results:
During a mean follow‐up of 2.92 years, appropriate therapy occurred in 27.7% and 54.0% of patients who had received an ICD for primary and secondary prevention of sudden cardiac death (SCD), respectively (P<0.0001). Inappropriate shock therapy occurred in 15.0% and 25.4% of patients who had received an ICD for primary and secondary prevention of SCD, respectively (P = 0.122). Appropriate ICD therapy had a strong impact on overall survival (P<0.0001), and this association was found both in primary (P<0.0001) and secondary (P = 0.002) prevention of SCD. Inappropriate ICD shocks had no impact on total mortality, neither in primary nor secondary prevention of SCD.
Conclusions:
Inappropriate shocks do not affect survival, in strong contrast to appropriate ICD therapy. Our study does not support the hypothesis that shock therapy in itself worsens clinical outcome. However, it confirms that appropriate ICD therapy is a warning sign and should prompt physicians to consider additional treatment strategies. © 2011 Wiley Periodicals, Inc.
The authors have no funding, financial relationships, or conflicts of interest to disclose.</description><identifier>ISSN: 0160-9289</identifier><identifier>EISSN: 1932-8737</identifier><identifier>DOI: 10.1002/clc.20910</identifier><identifier>PMID: 21678454</identifier><identifier>CODEN: CLCADC</identifier><language>eng</language><publisher>New York: Wiley Periodicals, Inc</publisher><subject>Aged ; Austria ; Biological and medical sciences ; Cardiology. Vascular system ; Clinical Investigation ; Clinical Investigations ; Death, Sudden, Cardiac - etiology ; Death, Sudden, Cardiac - prevention & control ; Defibrillators, Implantable - adverse effects ; Disease Progression ; Electric Countershock - adverse effects ; Electric Countershock - instrumentation ; Electric Countershock - mortality ; Equipment Failure ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Medical sciences ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Survival Rate ; Switzerland ; Tachycardia, Ventricular - complications ; Tachycardia, Ventricular - mortality ; Tachycardia, Ventricular - physiopathology ; Tachycardia, Ventricular - therapy ; Time Factors ; Treatment Outcome ; Ventricular Fibrillation - complications ; Ventricular Fibrillation - mortality ; Ventricular Fibrillation - physiopathology ; Ventricular Fibrillation - therapy</subject><ispartof>Clinical cardiology (Mahwah, N.J.), 2011-07, Vol.34 (7), p.433-436</ispartof><rights>2011 Wiley Periodicals, Inc.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4720-1c43b3d7a9334987ef3f8c2ad3630b53310c6bae7d0b7c3205bc2607fe8e470a3</citedby><cites>FETCH-LOGICAL-c4720-1c43b3d7a9334987ef3f8c2ad3630b53310c6bae7d0b7c3205bc2607fe8e470a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6652665/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6652665/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24396462$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21678454$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dichtl, Wolfgang</creatorcontrib><creatorcontrib>Wolber, Thomas</creatorcontrib><creatorcontrib>Paoli, Ursula</creatorcontrib><creatorcontrib>Brüllmann, Simon</creatorcontrib><creatorcontrib>Stühlinger, Markus</creatorcontrib><creatorcontrib>Berger, Thomas</creatorcontrib><creatorcontrib>Spuller, Karin</creatorcontrib><creatorcontrib>Strasak, Alexander</creatorcontrib><creatorcontrib>Pachinger, Otmar</creatorcontrib><creatorcontrib>Haegeli, Laurent M.</creatorcontrib><creatorcontrib>Duru, Firat</creatorcontrib><creatorcontrib>Hintringer, Florian</creatorcontrib><title>Appropriate Therapy But Not Inappropriate Shocks Predict Survival in Implantable Cardioverter Defibrillator Patients</title><title>Clinical cardiology (Mahwah, N.J.)</title><addtitle>Clin Cardiol</addtitle><description>Background:
Inappropriate implantable cardioverter defibrillator (ICD) shocks have been linked to a worse clinical outcome due to direct myocardial injury.
Hypothesis:
The occurrence of ventricular tachyarrhythmia indicating progression of the underlying heart disease, but not the ICD shock itself, has prognostic impact in clinical routine.
Methods:
In a retrospective study, 1117 recipients of an ICD were analyzed with respect to appropriate and inappropriate therapies and survival.
Results:
During a mean follow‐up of 2.92 years, appropriate therapy occurred in 27.7% and 54.0% of patients who had received an ICD for primary and secondary prevention of sudden cardiac death (SCD), respectively (P<0.0001). Inappropriate shock therapy occurred in 15.0% and 25.4% of patients who had received an ICD for primary and secondary prevention of SCD, respectively (P = 0.122). Appropriate ICD therapy had a strong impact on overall survival (P<0.0001), and this association was found both in primary (P<0.0001) and secondary (P = 0.002) prevention of SCD. Inappropriate ICD shocks had no impact on total mortality, neither in primary nor secondary prevention of SCD.
Conclusions:
Inappropriate shocks do not affect survival, in strong contrast to appropriate ICD therapy. Our study does not support the hypothesis that shock therapy in itself worsens clinical outcome. However, it confirms that appropriate ICD therapy is a warning sign and should prompt physicians to consider additional treatment strategies. © 2011 Wiley Periodicals, Inc.
The authors have no funding, financial relationships, or conflicts of interest to disclose.</description><subject>Aged</subject><subject>Austria</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Clinical Investigation</subject><subject>Clinical Investigations</subject><subject>Death, Sudden, Cardiac - etiology</subject><subject>Death, Sudden, Cardiac - prevention & control</subject><subject>Defibrillators, Implantable - adverse effects</subject><subject>Disease Progression</subject><subject>Electric Countershock - adverse effects</subject><subject>Electric Countershock - instrumentation</subject><subject>Electric Countershock - mortality</subject><subject>Equipment Failure</subject><subject>Female</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Survival Rate</subject><subject>Switzerland</subject><subject>Tachycardia, Ventricular - complications</subject><subject>Tachycardia, Ventricular - mortality</subject><subject>Tachycardia, Ventricular - physiopathology</subject><subject>Tachycardia, Ventricular - therapy</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ventricular Fibrillation - complications</subject><subject>Ventricular Fibrillation - mortality</subject><subject>Ventricular Fibrillation - physiopathology</subject><subject>Ventricular Fibrillation - therapy</subject><issn>0160-9289</issn><issn>1932-8737</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNp1kUtv1DAUhS0EosPAgj-ALCGEWKT1I7GTDVIJr5FGUKllbd04DuPiiYPtDJp_j8sMpSCxsLy4n8655x6EnlJySglhZ9rpU0YaSu6hBW04K2rJ5X20IFSQomF1c4IexXidUVIz_hCdMCpkXVblAqXzaQp-ChaSwVcbE2Da4zdzwp98wqsR7kwvN15_i_gimN7qhC_nsLM7cNiOeLWdHIwJOmdwC6G3fmdCMgG_NYPtgnUOkg_4ApI1Y4qP0YMBXDRPjv8SfXn_7qr9WKw_f1i15-tCl5KRguqSd7yX0HBeNrU0Ax9qzaDngpOu4pwSLTowsied1JyRqtNMEDmY2pSSAF-i1wfdae62ptfZO4BTOc8Wwl55sOrvyWg36qvfKSEqll8WeHkUCP77bGJSWxu1yXFG4-eoainL3EA-6hI9_4e89nMYczpFKyrzvQURmXp1oHTwMQYz3O5CibqpUuUq1a8qM_vs7vK35O_uMvDiCEDU4IYAo7bxD1fyRpTiZrWzA_fDOrP_v6Nq1-3B-ifvh7cZ</recordid><startdate>201107</startdate><enddate>201107</enddate><creator>Dichtl, Wolfgang</creator><creator>Wolber, Thomas</creator><creator>Paoli, Ursula</creator><creator>Brüllmann, Simon</creator><creator>Stühlinger, Markus</creator><creator>Berger, Thomas</creator><creator>Spuller, Karin</creator><creator>Strasak, Alexander</creator><creator>Pachinger, Otmar</creator><creator>Haegeli, Laurent M.</creator><creator>Duru, Firat</creator><creator>Hintringer, Florian</creator><general>Wiley Periodicals, Inc</general><general>Wiley</general><general>John Wiley & Sons, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201107</creationdate><title>Appropriate Therapy But Not Inappropriate Shocks Predict Survival in Implantable Cardioverter Defibrillator Patients</title><author>Dichtl, Wolfgang ; Wolber, Thomas ; Paoli, Ursula ; Brüllmann, Simon ; Stühlinger, Markus ; Berger, Thomas ; Spuller, Karin ; Strasak, Alexander ; Pachinger, Otmar ; Haegeli, Laurent M. ; Duru, Firat ; Hintringer, Florian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4720-1c43b3d7a9334987ef3f8c2ad3630b53310c6bae7d0b7c3205bc2607fe8e470a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Austria</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Clinical Investigation</topic><topic>Clinical Investigations</topic><topic>Death, Sudden, Cardiac - etiology</topic><topic>Death, Sudden, Cardiac - prevention & control</topic><topic>Defibrillators, Implantable - adverse effects</topic><topic>Disease Progression</topic><topic>Electric Countershock - adverse effects</topic><topic>Electric Countershock - instrumentation</topic><topic>Electric Countershock - mortality</topic><topic>Equipment Failure</topic><topic>Female</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Survival Rate</topic><topic>Switzerland</topic><topic>Tachycardia, Ventricular - complications</topic><topic>Tachycardia, Ventricular - mortality</topic><topic>Tachycardia, Ventricular - physiopathology</topic><topic>Tachycardia, Ventricular - therapy</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ventricular Fibrillation - complications</topic><topic>Ventricular Fibrillation - mortality</topic><topic>Ventricular Fibrillation - physiopathology</topic><topic>Ventricular Fibrillation - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dichtl, Wolfgang</creatorcontrib><creatorcontrib>Wolber, Thomas</creatorcontrib><creatorcontrib>Paoli, Ursula</creatorcontrib><creatorcontrib>Brüllmann, Simon</creatorcontrib><creatorcontrib>Stühlinger, Markus</creatorcontrib><creatorcontrib>Berger, Thomas</creatorcontrib><creatorcontrib>Spuller, Karin</creatorcontrib><creatorcontrib>Strasak, Alexander</creatorcontrib><creatorcontrib>Pachinger, Otmar</creatorcontrib><creatorcontrib>Haegeli, Laurent M.</creatorcontrib><creatorcontrib>Duru, Firat</creatorcontrib><creatorcontrib>Hintringer, Florian</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dichtl, Wolfgang</au><au>Wolber, Thomas</au><au>Paoli, Ursula</au><au>Brüllmann, Simon</au><au>Stühlinger, Markus</au><au>Berger, Thomas</au><au>Spuller, Karin</au><au>Strasak, Alexander</au><au>Pachinger, Otmar</au><au>Haegeli, Laurent M.</au><au>Duru, Firat</au><au>Hintringer, Florian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Appropriate Therapy But Not Inappropriate Shocks Predict Survival in Implantable Cardioverter Defibrillator Patients</atitle><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle><addtitle>Clin Cardiol</addtitle><date>2011-07</date><risdate>2011</risdate><volume>34</volume><issue>7</issue><spage>433</spage><epage>436</epage><pages>433-436</pages><issn>0160-9289</issn><eissn>1932-8737</eissn><coden>CLCADC</coden><abstract>Background:
Inappropriate implantable cardioverter defibrillator (ICD) shocks have been linked to a worse clinical outcome due to direct myocardial injury.
Hypothesis:
The occurrence of ventricular tachyarrhythmia indicating progression of the underlying heart disease, but not the ICD shock itself, has prognostic impact in clinical routine.
Methods:
In a retrospective study, 1117 recipients of an ICD were analyzed with respect to appropriate and inappropriate therapies and survival.
Results:
During a mean follow‐up of 2.92 years, appropriate therapy occurred in 27.7% and 54.0% of patients who had received an ICD for primary and secondary prevention of sudden cardiac death (SCD), respectively (P<0.0001). Inappropriate shock therapy occurred in 15.0% and 25.4% of patients who had received an ICD for primary and secondary prevention of SCD, respectively (P = 0.122). Appropriate ICD therapy had a strong impact on overall survival (P<0.0001), and this association was found both in primary (P<0.0001) and secondary (P = 0.002) prevention of SCD. Inappropriate ICD shocks had no impact on total mortality, neither in primary nor secondary prevention of SCD.
Conclusions:
Inappropriate shocks do not affect survival, in strong contrast to appropriate ICD therapy. Our study does not support the hypothesis that shock therapy in itself worsens clinical outcome. However, it confirms that appropriate ICD therapy is a warning sign and should prompt physicians to consider additional treatment strategies. © 2011 Wiley Periodicals, Inc.
The authors have no funding, financial relationships, or conflicts of interest to disclose.</abstract><cop>New York</cop><pub>Wiley Periodicals, Inc</pub><pmid>21678454</pmid><doi>10.1002/clc.20910</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Austria Biological and medical sciences Cardiology. Vascular system Clinical Investigation Clinical Investigations Death, Sudden, Cardiac - etiology Death, Sudden, Cardiac - prevention & control Defibrillators, Implantable - adverse effects Disease Progression Electric Countershock - adverse effects Electric Countershock - instrumentation Electric Countershock - mortality Equipment Failure Female Humans Kaplan-Meier Estimate Male Medical sciences Retrospective Studies Risk Assessment Risk Factors Survival Rate Switzerland Tachycardia, Ventricular - complications Tachycardia, Ventricular - mortality Tachycardia, Ventricular - physiopathology Tachycardia, Ventricular - therapy Time Factors Treatment Outcome Ventricular Fibrillation - complications Ventricular Fibrillation - mortality Ventricular Fibrillation - physiopathology Ventricular Fibrillation - therapy |
| title | Appropriate Therapy But Not Inappropriate Shocks Predict Survival in Implantable Cardioverter Defibrillator Patients |
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