Prognostic impact of recurrences of ventricular tachyarrhythmias and appropriate ICD therapies in a high-risk ICD population

Schupp, Tobias; Akın, İbrahim; Reiser, Linda; Bollow, Armin; Taton, Gabriel; Reichelt, Thomas; Ellguth, Dominik; Engelke, Niko; Ansari, Uzair; Mashayekhi, Kambis; Weiß, Christel; Nienaber, Christoph; Akin, Muharrem; Borggrefe, Martin; Behnes, Michael

doi:10.1007/s00392-019-01416-y

Cited by 9 publications

(4 citation statements)

References 46 publications

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“…Besides increasing the risk of mortality, systolic HF represents one of the most common reasons for increasing the risk of ventricular tachyarrhythmias leading to appropriate device therapies 16,17 . Prescription of MRA was postulated to decrease the risk of ventricular tachyarrhythmias leading to SCD in various studies.…”

Section: Discussionmentioning

confidence: 99%

No impact of mineralocorticoid receptor antagonists on long‐term recurrences of ventricular tachyarrhythmias

Schupp

Akın

Reiser

et al. 2021

Pacing Clinical Electrophis

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Objective The study sought to assess the prognostic impact of treatment with mineralocorticoid receptor antagonists (MRA) on recurrences of ventricular tachyarrhythmias in implantable cardioverter‐defibrillator (ICD) recipients with systolic heart failure (HF). Background Data regarding the outcome of patients with ventricular tachyarrhythmias treated with MRA is limited. Methods A large retrospective registry was used including consecutive ICD recipients with systolic HF (i.e., left ventricular ejection fraction < 45%) and index episodes of ventricular tachyarrhythmias from 2002 to 2016. Patients treated with MRA were compared to patients without (non‐MRA). Kaplan–Meier and multivariable Cox regression analyses were applied for the evaluation of the primary endpoint defined as first recurrence of ventricular tachyarrhythmias at five years. Secondary endpoints were appropriate ICD therapies, first cardiac rehospitalization, and all‐cause mortality. Results 366 ICD recipients with systolic HF were included, 20% treated with MRA (spironolactone: 65%; eplerenone: 35%) and 80% without. At five years, treatment with MRA was not associated with the primary endpoint of first recurrence of ventricular tachyarrhythmias [47% vs. 48%, log‐rank p = 0.732; hazard ratio (HR) = 1.067; 95% confidence interval (CI) 0.736–1.546; p = 0.732]. Accordingly, risk of first appropriate ICD therapies, first cardiac rehospitalization, and all‐cause mortality were not affected by the presence of MRA therapy. Finally, patients with spironolactone and eplerenone had comparable risk of first recurrences of ventricular tachyarrhythmias (50% vs. 45%; p = 0.255; HR = 2.263; 95% CI 0.495–10.341; p = 0.292). Conclusion Treatment with MRA was not associated with recurrences of ventricular tachyarrhythmias and ICD therapies at five years.

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Section: Discussionmentioning

confidence: 99%

No impact of mineralocorticoid receptor antagonists on long‐term recurrences of ventricular tachyarrhythmias

Schupp

Akın

Reiser

et al. 2021

Pacing Clinical Electrophis

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“…Primary preventive ICD included patients with persistent LVEF less than 35% without sustained ventricular tachyarrhythmias of irreversible causes at the time of prior ICD implantation, or nonsustained VT at index with persistent LVEF less than 35% and ICD implantation at index. Secondary preventive ICDs included patients with ICD implantation at index hospitalization after the index episode of ventricular tachyarrhythmias of irreversible causes or patients with a prior history of sustained ventricular tachyarrhythmias of irreversible causes and prior consecutive ICD implantation before index hospitalization [13].…”

Section: Study Populationmentioning

confidence: 99%

Distribution and prognostic impact of coronary artery disease and nonischemic cardiomyopathies in patients with electrical storm

Müller

Behnes

Ellguth

et al. 2022

Coronary Artery Disease

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Background he distribution and prognostic impact of coronary artery disease (CAD) in ES are still under debate. Methods Consecutive ES patients with implantable cardioverter-defibrillator (ICD) were included retrospectively from 2002 to 2016. Three analyses were applied to characterize ES patients: (a) ES patients without CAD (non-CAD), (b) ES patients with CAD (CAD), and (c) diagnostic findings assessed by coronary angiography (CA) at the time of ES (immediate CA). CAD was compared with non-CAD ES patients, and progressive CAD was compared with stable CAD ES patients. The primary endpoint was all-cause mortality at 2.5 years. Secondary endpoints were the composite endpoint of first recurrent ventricular tachyarrhythmias and appropriate ICD therapies, and recurrence of ES (ES-R) at 2.5 years. Results Within a total of 87 consecutive ES patients. CAD was present in more than two-thirds (67%). However, only 52% patients underwent immediate CA at the time of ES. Here, 84% had CAD, of which 39% revealed progressive CAD with the need of target vessel revascularization (TVR) or cardiac transplantation (n = 1). At long-term follow-up, neither the presence (or absence) of CAD (41% vs. 34%; log rank P = 0.708) nor of progressive CAD (33% vs. 26%; log rank P = 0.372) was associated with all-cause mortality at 2.5 years, and further secondary endpoints including the composite of recurrent ventricular tachyarrhythmias plus appropriate ICD therapies, or ES-R. Conclusion In ES patients, CAD was more common than non-CAD-related cardiac diseases, accompanied by an underinvestigated rate of CA despite increasing rates of progressive CAD. CAD had no prognostic impact in ES.

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“…The present all-comers study retrospectively included all consecutive patients with index episodes of ventricular tachyarrhythmias on index hospital admission, who were discharged from our institution with an ICD between 2002 and 2016, as previously published. 16 The study was conducted in accordance with the Basic & Clinical Pharmacology & Toxicology policy for experimental and clinical studies. 17 ICD recipients routinely presented every three to six months for device check and unscheduled in case of noticed device interrogations at our clinic.…”

Section: Data Collection and Documentationmentioning

confidence: 99%

Comparable risk of recurrent ventricular tachyarrhythmias in implantable cardioverter‐defibrillator recipients treated with single beta‐blocker or combined amiodarone

Schupp

Behnes

Kim

et al. 2020

Basic Clin Pharma Tox

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This study sought to assess the prognostic impact of treatment with single beta‐blocker (BB) compared to combined therapy with BB plus amiodarone (BB‐AMIO) on recurrences of ventricular tachyarrhythmias in implantable cardioverter‐defibrillator (ICD) recipients. A large retrospective registry was used including consecutive ICD recipients with index episodes of ventricular tachyarrhythmias from 2002 to 2016. Patients treated with BB were compared to patients treated with BB‐AMIO. Kaplan‐Meier and Cox regression analyses were applied for the evaluation of the primary end‐point defined as first recurrences of ventricular tachyarrhythmias at five years. Secondary end‐points comprised first appropriate ICD therapies, first cardiac rehospitalization and all‐cause mortality at five years. Among 512 ICD recipients, 81% were treated with BB and 19% with BB‐AMIO. BB and BB‐AMIO were associated with comparable risk of first recurrences of ventricular tachyarrhythmias (46% vs. 43%; log rank P = .941; HR = 1.013; 95% CI 0.725‐1.415; P = .941) and appropriate ICD therapies (35% vs. 37%; log rank P = .389; HR = 0.852; 95% CI 0.591‐1.228; P = .390). BB was associated with decreased long‐term all‐cause mortality within an univariable analysis only (20% vs. 28%; log rank p = 0.023). In conclusion, BB and BB‐AMIO were associated with comparable risks regarding recurrences of ventricular tachyarrhythmias at five years.

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Prognostic impact of recurrences of ventricular tachyarrhythmias and appropriate ICD therapies in a high-risk ICD population

Cited by 9 publications

References 46 publications

No impact of mineralocorticoid receptor antagonists on long‐term recurrences of ventricular tachyarrhythmias

No impact of mineralocorticoid receptor antagonists on long‐term recurrences of ventricular tachyarrhythmias

Distribution and prognostic impact of coronary artery disease and nonischemic cardiomyopathies in patients with electrical storm

Comparable risk of recurrent ventricular tachyarrhythmias in implantable cardioverter‐defibrillator recipients treated with single beta‐blocker or combined amiodarone

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