Risk Factors for Appropriate Cardioverter-Defibrillator Shocks, Inappropriate Cardioverter-Defibrillator Shocks, and Time to Mortality in 549 Patients With Heart Failure

Desai, Harit; Aronow, Wilbert S.; Ahn, Chul; Gandhi, Kaushang; Hussain, Sarwat; Lai, Hoang M.; Sharma, Mala; Frishman, William H.; Cohen, Martin; Sorbera, Carmine

doi:10.1016/j.amjcard.2009.12.057

Cited by 43 publications

(31 citation statements)

References 12 publications

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“…For one, the increased use of statins in this patient group may contribute to the lower risk of inappropriate therapy, as previously described, 13,33,34 but our results were consistent even after adjustment for statin use in the multivariate analyses. In addition, statin use might generally be related to a lower risk of atrial fibrillation, a reduction in atherosclerotic progression, and effects on serum lipids 35,36 rather than a reduced risk of SVT and sinus tachycardia, as we observed in this trial in patients with diabetes mellitus.…”

Section: Discussionsupporting

confidence: 78%

“…Our finding that diabetes mellitus is associated with an increased risk of appropriate therapy supports 2 previous studies, 7,11 but compared with the predictors of appropriate therapy previously found in the larger trials such as Multicenter Automatic Defibrillator Implantation Trial II (MADIT-II), Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT), Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION), Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction (REVERSE), Cardiac Resynchronization-Heart Failure (CARE-HF), and others, this is a novel finding. [12][13][14][15][16][17][18][19][20][21] Our explanation for the risk association of diabetes mellitus with appropriate ICD therapy includes a vulnerable myocardium resulting from fibrosis, ischemia, and scar tissue; reduced autonomic function; and reduced coronary circulation in diabetics, [22][23][24][25] rendering the myocardium more prone to produce ventricular arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

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Influence of Diabetes Mellitus on Inappropriate and Appropriate Implantable Cardioverter-Defibrillator Therapy and Mortality in the Multicenter Automatic Defibrillator Implantation Trial–Reduce Inappropriate Therapy (MADIT-RIT) Trial

et al. 2013

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T he Multicenter Automatic Defibrillator Implantation TrialReduce Inappropriate Therapy (MADIT-RIT) showed that innovative implantable cardioverter-defibrillator (ICD) programming was associated with a reduction in inappropriate therapy and mortality.1 The MADIT-RIT trial randomized patients with a primary prophylactic ICD indication to 3 different types of ICD programming: conventional programming with a ventricular tachycardia (VT) zone of 170 to 199 bpm, high-rate cutoff with a VT zone ≥200 bpm, or 60-seconddelayed therapy during a VT zone of 170 to 199 bpm. Clinical Perspective on p 701Background-The relationship between diabetes mellitus and risk of inappropriate or appropriate therapy in patients receiving an implantable cardioverter-defibrillator (ICD) and resynchronization therapy has not been investigated thoroughly. The effect of innovative ICD programming on therapy delivery in these patients is unknown. Methods and Results-The Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT) randomized patients with a primary prophylactic ICD indication to 3 different types of ICD programming: conventional programming with a ventricular tachycardia zone of 170 to 199 bpm (arm A), high-rate cutoff with a ventricular tachycardia zone ≥200 bpm (arm B), or 60-second-delayed therapy (arm C). The end points of inappropriate therapy, appropriate therapy, and death were assessed among 485 patients with and 998 without diabetes mellitus. Innovative ICD programming reduced the risk of inappropriate therapy regardless of diabetes mellitus, although a trend toward a more pronounced effect of high-rate cutoff programming was seen in patients without diabetes mellitus (P for interaction=0.06). Diabetes mellitus was associated with a decreased risk of inappropriate therapy (hazard ratio, 0.54; 95% confidence interval, 0.36-0.80; P=0.002) and increased risk of appropriate therapy (hazard ratio,1.58; 95% confidence interval, 1.17-2.14; P=0.003). In diabetic patients, there was significantly increased risk of death in those who had inappropriate therapy (hazard ratio, 4.17; 95% confidence interval, 1.52-11.40; P=0.005) and appropriate therapy (hazard ratio, 2.49; 95% confidence interval, 1.06-5.87; P=0.037) compared with those who did not. Conclusions-Innovative high-rate cutoff or delayed ICD programming was associated with a reduction in inappropriate therapy in patients with and without diabetes mellitus. Diabetes mellitus was associated with lower risk of inappropriate therapy but higher risk of appropriate therapy. Ruwald et al Diabetes Mellitus and ICD Programming and Therapy 695Diabetes mellitus is a growing burden to the healthcare system. It affects 25.8 million of the US population (8.3%) and is a major cause of heart disease and stroke. In ICD patients, diabetes mellitus is associated with an increased risk of hospitalization for heart failure, sudden cardiac death, and all-cause mortality 2-6 ; however, the association between diabetes mellitus and inappropriate and appropria...

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Influence of Diabetes Mellitus on Inappropriate and Appropriate Implantable Cardioverter-Defibrillator Therapy and Mortality in the Multicenter Automatic Defibrillator Implantation Trial–Reduce Inappropriate Therapy (MADIT-RIT) Trial

et al. 2013

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“…In a recent study by Desai and colleagues In the present study of 549 patients with heart failure and ICDs, smoking significantly increased the incidence of appropriate ICD shocks 3.7 times, and the use of statins significantly reduced appropriate ICD shocks by 46%. 23 This is consistent with previous results from the MADIT II trial. 24,25 …”

Section: Discussionsupporting

confidence: 83%

Prognostic Significance of Implantable Cardioverter-Defibrillator Shocks

Blendea¹,

Dadu²,

McPherson³

2011

Cardiac Defibrillation - Prediction, Prevention and Management of Cardiovascular Arrhythmic Events

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“…Further, nicotine has been shown to stimulate the sympathetic nerves and markedly elevate serum catecholamine concentration, which is potentially arrhythmogenic (18). Smoking is indeed a significant risk factor for appropriate ICD shocks among patients with heart failure with an ICD (19)(20)(21). However, it is not certain whether smoking by itself is a risk for idiopathic Vf.…”

Section: Retrospective Survey Of the Medical Recordmentioning

confidence: 99%

Graves' Disease Complicated by Ventricular Fibrillation in Three Men Who Were Smokers

Ando

Henmi²,

Haruta³

et al. 2011

Thyroid

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Background: Thyrotoxicosis is known to be associated with sinus tachycardia and supraventricular tachyarrhythmias, but rarely with ventricular fibrillation (Vf), which has only occurred in some patients with hypokalemic periodic paralysis or ischemic heart disease. Patient Findings: We present three men who were transferred to our hospital with Graves' disease who developed idiopathic Vf. None of them had hypokalemic periodic paralysis or ischemic heart disease but all were smokers. None of other patients with thyrotoxicosis (587 females and 155 males) who were seen at our hospital, in the period during which the three men were seen, had idiopathic Vf. In our three men with thyrotoxicosis and idiopathic Vf, there was no identifiable underlying heart disease. One of the three patients died of hypoxic encephalopathy. The other two men did not have recurrent Vf after their thyroid function normalized. Summary: These cases and a review of similar cases in the literature imply that improving thyrotoxicosis seems to be effective for treating idiopathic Vf in some patients. Conclusions: Our findings suggest that thyroid hormone excess might play a direct role in the development of Vf in susceptible individuals. Our experience with these three patients suggests that smoking men with thyrotoxicosis likely have an increased risk for Vf, even if they do not have other predisposing factors.

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Risk Factors for Appropriate Cardioverter-Defibrillator Shocks, Inappropriate Cardioverter-Defibrillator Shocks, and Time to Mortality in 549 Patients With Heart Failure

Cited by 43 publications

References 12 publications

Influence of Diabetes Mellitus on Inappropriate and Appropriate Implantable Cardioverter-Defibrillator Therapy and Mortality in the Multicenter Automatic Defibrillator Implantation Trial–Reduce Inappropriate Therapy (MADIT-RIT) Trial

Influence of Diabetes Mellitus on Inappropriate and Appropriate Implantable Cardioverter-Defibrillator Therapy and Mortality in the Multicenter Automatic Defibrillator Implantation Trial–Reduce Inappropriate Therapy (MADIT-RIT) Trial

Prognostic Significance of Implantable Cardioverter-Defibrillator Shocks

Graves' Disease Complicated by Ventricular Fibrillation in Three Men Who Were Smokers

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