Circannual Variation of Malignant Ventricular Tachyarrhythmias in Patients With Implantable Cardioverter-Defibrillators and Either Coronary Artery Disease or Idiopathic Dilated Cardiomyopathy

Fries, Roland; Heisel, Armin; Jung, Jens; Schieffer, Hermann

doi:10.1016/s0002-9149(97)00081-7

Cited by 36 publications

(23 citation statements)

References 16 publications

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“…Possible explanations advanced for this phenomenon in the general population are hemoconcentration and an increased tendency for thrombosis (13,16), although it remains to be determined whether this phenomenon would also play a role in dialysis patients. Other factors, such as variations in sympathetic nervous system activity, might also contribute to an increased propensity for arrhythmias (17,18), although no seasonal variations in catecholamine excretion have been observed in nonuremic patients (19).…”

Section: Discussionmentioning

confidence: 99%

Seasonal Variations in Mortality, Clinical, and Laboratory Parameters in Hemodialysis Patients

Usvyat

Carter

Thijssen

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Mortality varies seasonally in the general population, but it is unknown whether this phenomenon is also present in hemodialysis patients with known higher background mortality and emphasis on cardiovascular causes of death. This study aimed to assess seasonal variations in mortality, in relation to clinical and laboratory variables in a large cohort of chronic hemodialysis patients over a 5-year period.Design, setting, participants, & measurements This study included 15,056 patients of 51 Renal Research Institute clinics from six states of varying climates in the United States. Seasonal differences were assessed by chi-squared tests and univariate and multivariate cosinor analyses.Results Mortality, both all-cause and cardiovascular, was significantly higher during winter compared with other seasons (14.2 deaths per 100 patient-years in winter, 13.1 in spring, 12.3 in autumn, and 11.9 in summer). The increase in mortality in winter was more pronounced in younger patients, as well as in whites and in men. Seasonal variations were similar across climatologically different regions. Seasonal variations were also observed in neutrophil/lymphocyte ratio and serum calcium, potassium, and platelet values. Differences in mortality disappeared when adjusted for seasonally variable clinical parameters. ConclusionsIn a large cohort of dialysis patients, significant seasonal variations in overall and cardiovascular mortality were observed, which were consistent over different climatic regions. Other physiologic and laboratory parameters were also seasonally different. Results showed that mortality differences were related to seasonality of physiologic and laboratory parameters. Seasonal variations should be taken into account when designing and interpreting longitudinal studies in dialysis patients.

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Section: Discussionmentioning

confidence: 99%

Seasonal Variations in Mortality, Clinical, and Laboratory Parameters in Hemodialysis Patients

Usvyat

Carter

Thijssen

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…What seems more plausible in explaining how activities might elicit defibrillator discharges is a vulnerability model that includes interacting factors of left ventricular dysfunction, electrical instability, and ischemia. Returning to Figure Regarding poSSible mechanisms for the seasonal effects seen in this study, the hypothesis presented by Fries et aL (1997) is that the increase in arrhythmic events during winter months is tied to thermal extremes and the stress those extremes place on the body.…”

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confidence: 67%

Possible Triggers and Temporal Patterns of Implantable Cardioverter Defibrillator Discharges: A Preliminary Study

Tucker¹

1999

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The present study investigated: (1) mental and physical activities as possible triggers of implantable cardioverter defibrillator discharges; and (2) the temporal patterns of those di scharges in order to provide the rationale for a larger~sca le study.Retrospecti ve interviews of patients with coronary artery disease and implantable cardioverter defibrillators were conducted to determine frequency of discharges and timing of discharges as well as specific circumstances surrounding those discharges. The interview also collected information regarding the usual activity levels of the patients to serve as control or baseline data. The case-crossover method was used to approach the data of 32 patients who were interviewed. Over a two-year period, 20 of the 32 patients had experienced discharges. Elevated Mantel-Haenszel estimates of relative risk were found for high physical exertion, sexual activity, high mental activity, tension or stress, and anger, but these elevated risks were statistically non-significant given this small sample size. Chi-square analysis of a circadian pattern of discharges was statistically non-significant, but there was evidence of a seasonal variation in number of discharges ("t}= 9.00, p=O.029). This seasonal pattern revealed a peak prevalence of incidents during the winter months and a smaller peak during summer months.

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“…Observations from long‐distance running races suggest that ischemia burden alone may be sufficient to cause ventricular dysrhythmias and cardiac death 38. Moreover, cold stress may directly provoke arrhythmic cardiac death, through data demonstrating increased frequency of ventricular dysrhythmias during cold temperatures in patients with implanted cardioverter‐defibrillators 39. Additionally, cold air inhalation may increase the likelihood of a plaque rupture event.…”

Section: Discussionmentioning

confidence: 99%

Deleterious Effects of Cold Air Inhalation on Coronary Physiological Indices in Patients With Obstructive Coronary Artery Disease

Williams

Asrress

Lumley

et al. 2018

JAHA

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BackgroundCold air inhalation during exercise increases cardiac mortality, but the pathophysiology is unclear. During cold and exercise, dual‐sensor intracoronary wires measured coronary microvascular resistance (MVR) and blood flow velocity (CBF), and cardiac magnetic resonance measured subendocardial perfusion.Methods and ResultsForty‐two patients (62±9 years) undergoing cardiac catheterization, 32 with obstructive coronary stenoses and 10 without, performed either (1) 5 minutes of cold air inhalation (5°F) or (2) two 5‐minute supine‐cycling periods: 1 at room temperature and 1 during cold air inhalation (5°F) (randomized order). We compared rest and peak stress MVR, CBF, and subendocardial perfusion measurements. In patients with unobstructed coronary arteries (n=10), cold air inhalation at rest decreased MVR by 6% (P=0.41), increasing CBF by 20% (P<0.01). However, in patients with obstructive stenoses (n=10), cold air inhalation at rest increased MVR by 17% (P<0.01), reducing CBF by 3% (P=0.85). Consequently, in patients with obstructive stenoses undergoing the cardiac magnetic resonance protocol (n=10), cold air inhalation reduced subendocardial perfusion (P<0.05). Only patients with obstructive stenoses performed this protocol (n=12). Cycling at room temperature decreased MVR by 29% (P<0.001) and increased CBF by 61% (P<0.001). However, cold air inhalation during cycling blunted these adaptations in MVR (P=0.12) and CBF (P<0.05), an effect attributable to defective early diastolic CBF acceleration (P<0.05) and associated with greater ST‐segment depression (P<0.05).ConclusionsIn patients with obstructive coronary stenoses, cold air inhalation causes deleterious changes in MVR and CBF. These diminish or abolish the normal adaptations during exertion that ordinarily match myocardial blood supply to demand.

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Circannual Variation of Malignant Ventricular Tachyarrhythmias in Patients With Implantable Cardioverter-Defibrillators and Either Coronary Artery Disease or Idiopathic Dilated Cardiomyopathy

Cited by 36 publications

References 16 publications

Seasonal Variations in Mortality, Clinical, and Laboratory Parameters in Hemodialysis Patients

Seasonal Variations in Mortality, Clinical, and Laboratory Parameters in Hemodialysis Patients

Possible Triggers and Temporal Patterns of Implantable Cardioverter Defibrillator Discharges: A Preliminary Study

Deleterious Effects of Cold Air Inhalation on Coronary Physiological Indices in Patients With Obstructive Coronary Artery Disease

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