Cardiac Amyloidosis Treated with an Implantable Cardioverter Defibrillator and Subcutaneous Array Lead System: Report of a Case and Literature Review

Dhoble, Abhijeet; Khasnis, Atul; Olomu, Adesuwa; Thakur, Ranjan K.

doi:10.1002/clc.20389

Cited by 35 publications

(18 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(a) cardiac arrhythmias are common in patients with CA, with AF being the most common; (b) cardiac arrhythmias complicating CA were associated with worse in-hospital outcomes, increased length of stay, and higher cost of hospitalization; and (c) the rate of ICD implantation has been increasing over time and is associated with improved short term mortality in patients with CA.Falk et al showed that complex ventricular and supraventricular arrhythmias are common in patients with CA on ambulatory electrocardiography and despite the relatively low mortality in this study, 33% patients with more complex arrhythmias suffered from sudden cardiac death 6. This has been demonstrated in other studies, with a prevalence of VAs documented as high as 27% in patients with CA 14,19,20. .…”

supporting

confidence: 65%

Trends, burden, and impact of arrhythmia on cardiac amyloid patients: A 16‐year nationwide study from 1999 to 2014

Isath

Correa²,

Siroky³

et al. 2020

Journal of Arrhythmia

View full text Add to dashboard Cite

Background Patients with cardiac amyloidosis (CA) have increased mortality, which can be explained in part by an increased risk of arrhythmias. The burden of arrhythmias in CA, their predictors, and impact on in‐hospital outcomes remains unclear. The role of implantable cardioverter‐defibrillators (ICD) in this population is also uncertain. Methods We queried the National Inpatient Sample (NIS) using ICD‐9‐CM codes 277.39 and 425.7 to identify CA. Twelve common arrhythmias were extracted using appropriate, validated ICD‐9‐CM codes. ICD implantation was identified using procedure ICD‐9 codes 37.94 to 37.98, 00.51 and 00.54. Results There were a total of 145,920 CA hospitalizations between 1999 and 2014 in the United States and 56,199 (38.5%) of them were associated with arrhythmias. The prevalence of arrhythmias remained relatively constant from 41.5% in 1999 to 40.2% in 2014. The most common arrhythmia was atrial fibrillation (25.4%). In‐patient mortality was significantly higher in CA patients with arrhythmias (10.4% vs 6.5%, P < .001). ICD implantation was performed in 1,381 (0.94%) patients with CA and analysis revealed an incremental trend in implantation over the study period (0.48% in 1999 to 0.65% in 2014). In‐hospital mortality was significantly lower in patients who underwent ICD implantation (3.7% vs 8%; P = .0078). CA patients with arrhythmias also had an increased cost of hospitalization and length of stay ($65,046 ± 1,079 vs $53,322 ± 687 and 8.3 ± 0.1 vs 7.4 ± 0.1 days, respectively; P < .0001). Conclusion Cardiac arrhythmias are common in patients with CA and are associated with worse in‐hospital outcomes, increased length of stay, and cost of hospitalization.

show abstract

supporting

confidence: 65%

Trends, burden, and impact of arrhythmia on cardiac amyloid patients: A 16‐year nationwide study from 1999 to 2014

Isath

Correa²,

Siroky³

et al. 2020

Journal of Arrhythmia

View full text Add to dashboard Cite

show abstract

“…In the absence of evidence, pacing indications remain within current standard guidelines. High defibrillator thresholds may be encountered, and the benefits of such devices remain uncertain . Biventricular pacing appears to play little role but may be the ideal pacing option to avoid decompensation of the stiffened ventricle as a result of induced dyssynchrony from right ventricular pacing …”

Section: Treatmentmentioning

confidence: 99%

Updates in Cardiac Amyloidosis: A Review

Banypersad

Moon

Whelan

et al. 2012

JAHA

230

204

View full text Add to dashboard Cite

“…In contrast, regardless of the low incidence of ventricular arrhythmia, ICD implantation was selected for preventing SCD as previously reported [16,17]. Therefore, it is difficult to decide when to perform an ICD implantation.…”

Section: Discussionmentioning

confidence: 95%

Anti‐arrhythmic device therapy has limits in improving the prognosis of patients with cardiac amyloidosis

Kojima

Imai

Fujiu

et al. 2012

Journal of Arrhythmia

View full text Add to dashboard Cite

Immunoglobulin light chain (AL) amyloidosis has poor long‐term prognosis. Sudden cardiac death (SCD) is a common cause of death in patients with cardiac AL amyloidosis. Prophylactic anti‐arrhythmic device therapy has been suggested as an option to reduce this risk. We address this issue by reviewing 4 cases of cardiac AL amyloidosis with anti‐arrhythmic device therapy. One patient who had an atrioventricular block underwent pacemaker implantation, and the other 3 patients received implantable cardioverter‐defibrillator (ICD) implantation for ventricular arrhythmia. All of the 3 ICD implantation cases received appropriate shock therapy for ventricular arrhythmia in the early stage. However, they soon died due to pulseless electrical activity (PEA) or severe heart failure. The median survival period for our 4 cases was as short as 12.3 months. In particular, the 3 patients who required ICD had worse prognoses. Thus, ICD implantation therapy for chemotherapy‐resistant cardiac AL amyloidosis may prevent SCD but may not prolong the patient's survival. There are no arguments against pacemaker implantation for cardiac amyloidosis with conduction disturbance; however, the clinical benefit of ICD indication for ventricular tachyarrhythmia is limited. Further extensive clinical research should be performed to definitively determine the effects of ICD implantation on cardiac AL amyloidosis.

show abstract

Cardiac Amyloidosis Treated with an Implantable Cardioverter Defibrillator and Subcutaneous Array Lead System: Report of a Case and Literature Review

Cited by 35 publications

References 12 publications

Trends, burden, and impact of arrhythmia on cardiac amyloid patients: A 16‐year nationwide study from 1999 to 2014

Trends, burden, and impact of arrhythmia on cardiac amyloid patients: A 16‐year nationwide study from 1999 to 2014

Updates in Cardiac Amyloidosis: A Review

Anti‐arrhythmic device therapy has limits in improving the prognosis of patients with cardiac amyloidosis

Contact Info

Product

Resources

About