medigraphic.com
ISSN 2078-7170 (Electronic)

2020, Number 3

<< Back Next >>

CorSalud 2020; 12 (3)

Follow-up of the patient with automatic implantable cardioverter-defibrillator

Cruz CM, Prieto GM, Gutiérrez LA, Mengana BA, Ramos CMY, Tannis WE, Tamargo BTO

Language: Spanish
References: 36
Page: 283-291
PDF size: 743.35 Kb.


ABSTRACT

Introduction: Implantable cardioverter-defibrillators improve the survival of patients at risk of sudden cardiac death. There is relatively little data in our country about their follow-up effectiveness.
Objective: To describe the outcome of patients with primo-implantation of an automatic cardioverter-defibrillator during follow-up.
Methods: An ambispective longitudinal cohort study was conducted in 47 patients with primo-implantation of a cardioverter-defibrillator in the period September 2007 to December 2016, ending on December 31, 2017. The cumulative probability of survival was estimated through the Kaplan-Meier curves.
Results: Mean age was 57 ± 14.6 years, with male predominance (74.5%) and indication in secondary prevention (83%). Adequate therapies were found in 57.4% of patients, inadequate therapies in 23.4%, implantable cardioverter-defibrillator proarrhythmia in 14.9% and arrhythmic storm in 12.8% of patients. Adequate therapies were related to an ejection fraction ≤ 35% (p=0.022) and age (p=0.031). Cumulative free survival from the first event at four years was 34,7%. Cardiovascular mortality was related to: existence of structural heart disease (p=0.044), ejection fraction ≤ 35% (p<0.001), functional class III-IV (p=0.046), adequate therapies (p=0.014) and arrhythmic storm (p=0.002). Cumulative free survival of cardiovascular mortality was 70.7% at the fourth year.
Conclusions: The survival of patients with implantable cardioverter-defibrillator is satisfactory. Mortality is associated with further deterioration of cardiovascular status and with device therapies.


REFERENCES

  1. Lewis ME, Lin FC, Nanavati P, Mehta N, Mounsey L, Nwosu A, et al. Estimated incidence and risk factors of sudden unexpected death. Open Heart [Internet]. 2016 [citado 11 Dic 2019];3(1):e000321. Disponible en: http://doi.org/10.1136/openhrt-2015-000321

  2. Bayés de Luna A, Elosua R. Muerte Súbita. Rev Esp Cardiol. 2012;65(11):1039-52.

  3. Myerburg RJ, Junttila MJ. Sudden cardiac death caused by coronary heart disease. Circulation. 2012;125(8):1043-52.

  4. Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N Engl J Med. 1997;337(22):1576-83.

  5. Connolly SJ, Gent M, Roberts RS, Dorian P, Roy D, Sheldon RS, et al. Canadian implantable defibrillator study (CIDS): a randomized trial of the implantable cardioverter defibrillator against amiodarone. Circulation. 2000;101(11):1297-302.

  6. Kuck KH, Cappato R, Siebels J, Rüppel R. Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest: the Cardiac Arrest Study Hamburg (CASH). Circulation. 2000;102(7):748-54.

  7. Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med. 2005;352(3):225-37.

  8. Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H, et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. N Engl J Med. 1996;335(26):1933-40.

  9. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346(12):877-83.

  10. Alzueta J, Fernández-Lozano I, Barrera A. Registro Español de Desfibrilador Automático Implantable. XII Informe Oficial de la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología (2015). Rev Esp Cardiol. 2016;69(12):1168-79.

  11. Dubner S, Valero E, Pesce R, Zuelgaray JG, Mateos JC, Filho SG, Reyes W, Garillo R. A Latin American registry of implantable cardioverter defibrillators: the ICD-LABOR study. Ann Noninvasive Electrocardiol. 2005;10(4):420-8.

  12. Alzueta-Rodríguez J, Fernández-Pastor J, Ruiz-Salas A. Indicaciones y utilización del desfibrilador automático implantable ¿está infrautilizada esta terapia en nuestro medio? Cardiocore. 2015;50(3):115-8.

  13. Narbondo F, Pouso J, Varela G, Calleriza F, Do Mato G, Reyes W. Cardiodesfibriladores implantables. Diecinueve años de experiencia en un centro de nuestro país. Rev Urug Cardiol. 2013;28(2):141-50.

  14. Arribas F, López-Gil M, Salguero R, Chimero R. Algunos aspectos relacionados con la implantación del desfibrilador automático implantable. Rev Esp Cardiol Supl. 2008;8(A):51-64.

  15. Ezzat VA, Lee V, Ahsan S, Chow AW, Segal O, Rowland E, et al. A systematic review of ICD complications in randomised controlled trials versus registries: is our 'real-world' data an underestimation? Open Heart [Internet]. 2015 [citado 14 Dic 2019];2(1):e000198. Disponible en: http://doi.org/10.1136/openhrt-2014-000198

  16. van Rees JB, de Bie MK, Thijssen J, Borleffs CJ, Schalij MJ, van Erven L. Implantation-related complications of implantable cardioverter-defibrillators and cardiac resynchronization therapy devices: a systematic review of randomized clinical trials. J Am Coll Cardiol. 2011;58(10):995-1000.

  17. Abboud J, R Ehrlich J. Antiarrhythmic drug therapy to avoid implantable cardioverter defibrillator shocks. Arrhythm Electrophysiol Rev. 2016;5(2):117-21.

  18. Duray GZ, Schmitt J, Richter S, Israel CW, Hohnloser SH. Arrhythmic death in implantable cardioverter defibrillator patients: a long-term study over a 10 year implantation period. Europace. 2009;11(11):1462-8.

  19. Dorantes Sánchez M. Complicaciones del cardioversor-desfibrilador automático implantable: Tormenta eléctrica arrítmica. Rev Cuban Invest Bioméd [Internet] 2011 [citado 15 Dic 2019];30(4):537-54. Disponible en: http://scielo.sld.cu/pdf/ibi/v30n4/ibi11411.pdf

  20. Dichtl W, Wolber T, Paoli U, Brüllmann S, Stühlinger M, Berger T, et al. Appropriate therapy but not inappropriate shocks predict survival in implantable cardioverter defibrillator patients. Clin Cardiol. 2011;34(7):433-6.

  21. Borleffs CJ, van Erven L, Schotman M, Boersma E, Kiès P, van der Burg AE, et al. Recurrence of ventricular arrhythmias in ischaemic secondary prevention implantable cardioverter defibrillator recipients: long-term follow-up of the Leiden out-of-hospital cardiac arrest study (LOHCAT). Eur Heart J. 2009;30(13):1621-6.

  22. Schaer B, Kühne M, Reichlin T, Osswald S, Sticherling C. Incidence of and predictors for appropriate implantable cardioverter-defibrillator therapy in patients with a secondary preventive implantable cardioverter-defibrillator indication. Europace. 2016;18(2):227-31.

  23. Blumer J, Wolber T, Hellermann J, Holzmeister J, Binggeli C, Duru F, et al. Predictors of appropriate implantable cardioverter-defibrillator therapy during long-term follow-up of patients with coronary artery disease. Int Heart J. 2009;50(3):313-21.

  24. Lelakowski J, Piekarz J, Rydlewska A, Majewski J, Senderek T, Zabek A, et al. Factors predisposing to ventricular tachyarrhythmia leading to appropriate ICD intervention in patients with coronary artery disease or non-ischaemic dilated cardiomyopathy. Kardiol Pol. 2012;70(12):1264-75.

  25. Álvarez M. Urgencias en pacientes portadores de desfibrilador automático implantable. Rev Esp Cardiol Supl. 2008;8(A):31-9.

  26. Tornés F, Cisneros P, Dorantes M, Castro J, Zayas R, Quiñones MA, et al. Tormenta eléctrica arrítmica en pacientes con cardioversor-desfibrilador automático implantable. Arch Cardiol Mex. 2008;78(1):68-78.

  27. Verma A, Kilicaslan F, Marrouche NF, Minor S, Khan M, Wazni O, et al. Prevalence, predictors, and mortality significance of the causative arrhythmia in patients with electrical storm. J Cardiovasc Electrophysiol. 2004;15(11):1265-70.

  28. Klein RC, Raitt MH, Wilkoff BL, Beckman KJ, Coromilas J, Wyse DG, et al. Analysis of implantable cardioverter defibrillator therapy in the Antiarrhythmics Versus Implantable Defibrillators (AVID) Trial. J Cardiovasc Electrophysiol. 2003;14(9):940-8.

  29. Wathen MS, DeGroot PJ, Sweeney MO, Stark AJ, Otterness MF, Adkisson WO, et al. Prospective randomized multicenter trial of empirical antitachycardia pacing versus shocks for spontaneous rapid ventricular tachycardia in patients with implantable cardioverter-defibrillators: Pacing Fast Ventricular Tachycardia Reduces Shock Therapies (PainFREE Rx II) trial results. Circulation. 2004;110(17):2591-6.

  30. Thijssen J, Borleffs CJ, van Rees JB, Man S, de Bie MK, Venlet J, et al. Implantable cardioverter-defibrillator longevity under clinical circumstances: an analysis according to device type, generation, and manufacturer. Heart Rhythm. 2012;9(4):513-9.

  31. Karaoguz R, Maydanozcu S, Altun T, Güldal M, Akyürek O, Erol C. Appropriate ICD therapy in patients with idiopathic dilated cardiomyopathy: long term follow-up. Int Heart J. 2006;47(5):763-73.

  32. Katz DF, Peterson P, Borne RT, Betz J, Al-Khatib SM, Varosy PD, et al. Survival after secondary prevention implantable cardioverter-defibrillator placement: An Analysis From the NCDR ICD Registry. JACC Clin Electrophysiol. 2017;3(1):20-8.

  33. An Y, Ando K, Soga Y, Nomura A, Nagashima M, Hayashi K, Makihara Y, et al. Mortality and predictors of appropriate implantable cardioverter defibrillator therapy in Japanese patients with Multicenter Automatic Defibrillator Implantation Trial II criteria. J Arrhythm. 2017;33(1):17-22.

  34. Alba AC, Braga J, Gewarges M, Walter SD, Guyatt GH, Ross HJ. Predictors of mortality in patients with an implantable cardiac defibrillator: a systematic review and meta-analysis. Can J Cardiol. 2013;29(12):1729-40.

  35. Powell BD, Saxon LA, Boehmer JP, Day JD, Gilliam FR, Heidenreich PA, et al. Survival after shock therapy in implantable cardioverter-defibrillator and cardiac resynchronization therapy-defibrillator recipients according to rhythm shocked. The ALTITUDE survival by rhythm study. J Am Coll Cardiol. 2013;62(18):1674-9.

  36. Guerra F, Shkoza M, Scappini L, Flori M, Capucci A. Role of electrical storm as a mortality and morbidity risk factor and its clinical predictors: a meta-analysis. Europace. 2014;16(3):347-53.




2020     |     www.medigraphic.com