Predictors of appropriate ICD therapy in patients with implantable cardioverter-defibrillator

Dehghani, M.R. and Arya, A. and Haghjoo, M. and Emkanjoo, Z. and Alasti, M. and Kazemi, B. and Nikoo, M.H. and Sadr-Ameli, M.A. (2006) Predictors of appropriate ICD therapy in patients with implantable cardioverter-defibrillator. Indian Pacing and Electrophysiology Journal, 6 (1). pp. 17-24.


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Background: Understanding the predictors of appropriate implantable cardioverter defibrillator (ICD) therapy could help to better identify candidates for ICD implantation. Methods: One hundred and sixty two patients with ICD (111 with coronary artery disease CAD and 51 with dilated cardiomyopathy DCM) were included in the study. Clinical, electrocardiographic, and ICD stored data and electrograms were collected. Results: During mean follow up of 15±11 months 54 patients (33%) received � 1 appropriate ICD therapy (AICDT). We used binary logistic regression analysis with forward selection method to find the potential predictors of appropriate ICD therapy after device implantation. Male gender (odds ratio OR = 2.76, 95% confidence interval CI = 1.1 - 7.1, P=0.021), DCM as underlying heart disease (OR = 4.2, 95% CI = 1.9 - 9.5, P=0.001), and QRS width > 100 ms (OR = 2.58, 95% CI = 1.2 - 5.4, P=0.010) were correlated with increased likelihood of AICDT during the follow up period. In subgroup analysis of the patients with CAD and DCM, QRS duration > 100 ms was correlated with the probability of � 1 AICDT. In our patients indication of ICD implantation (primary versus secondary prevention) did not influence probability of � 1 AICDT (adjusted OR = 1.66, 95% CI = 0.7 - 4.0, Mantel-Haenszel P value P=0.355.) Conclusion: QRS width could be used as an additional simple risk stratifier beyond EF to identify potential candidates who would benefit more from ICD implantation. This may have practical implications for patient selection especially in developing countries. Indication of ICD implantation (primary versus secondary prevention) did not affect the probability of � 1 AICDT during the follow up period.

Item Type: Article
Additional Information: cited By 2
Uncontrolled Keywords: amiodarone; beta adrenergic receptor blocking agent; digoxin; dipeptidyl carboxypeptidase inhibitor; hydroxymethylglutaryl coenzyme A reductase inhibitor, adult; aged; article; clinical examination; confidence interval; congestive cardiomyopathy; controlled study; coronary artery disease; correlation analysis; defibrillator; developing country; electrocardiography; electrography; female; follow up; heart disease; human; information processing; logistic regression analysis; major clinical study; male; Mantel Haenszel test; medical instrumentation; patient selection; prediction; probability; QRS complex; quantitative analysis; risk benefit analysis; sex ratio; treatment indication
Subjects: WG Cardiovascular System
Depositing User: Librarian Farzaneh Dini
Date Deposited: 08 Apr 2020 07:06
Last Modified: 08 Apr 2020 07:06

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