Effect of cardiac resynchronization therapy on the incidence of ventricular arrhythmias in patients with an implantable cardioverter-defibrillator

Arya, A. and Haghjoo, M. and Dehghani, M.R. and Alasti, M. and Alizadeh, H. and Kazemi, B. and Sadr-Ameli, M.A. (2005) Effect of cardiac resynchronization therapy on the incidence of ventricular arrhythmias in patients with an implantable cardioverter-defibrillator. Heart Rhythm, 2 (10). pp. 1094-1098.

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Background: Cardiac resynchronization therapy (CRT) reduces mortality in selected patients with heart failure. However, this result may not be entirely related to the beneficial hemodynamic effects of CRT. Objectives: The purpose of this study was to assess retrospectively the effect of CRT on the incidence of appropriate therapy in patients with an implantable cardioverter-defibrillator (ICD). Methods: Sixty-five patients (48 men and 17 women; mean age 58 ± 13 years) with an ICD (31 biventricular, 34 dual-chamber) were included in the study. Clinical, ECG, and ICD stored data and electrograms were collected. Results: Biventricular and dual-chamber ICDs were implanted in 31 and 34 patients, respectively, who had either ischemic (n = 36) or dilated cardiomyopathy (n = 29). Thirty-two (49) patients received �1 appropriate ICD therapy during follow-up of 11 ± 8 months. Thirty-five percent and 62 of patients with biventricular (n = 11) and dual-chamber ICDs (n = 21), respectively, received appropriate ICD therapy during the follow-up period (odds ratio = 0.340, P = .048). Stratifying the patients according to underlying heart disease and ejection fraction resulted in an adjusted odds ratio = 0.239 (P = .029). Comparing the rate of �1 appropriate ICD therapy between the two groups by Kaplan-Meier analysis and the log rank test resulted in P = .027. Conclusion: In this retrospective analysis, biventricular pacing was associated with a decreased incidence of sustained ventricular arrhythmias requiring ICD therapy. The antiarrhythmic effect of biventricular pacing could contribute to the reduction in mortality reported in recent large-scale clinical trials on CRT. However, further prospective studies are warranted to clarify this issue. © 2005 Heart Rhythm Society. All rights reserved.

Item Type: Article
Additional Information: cited By 50
Uncontrolled Keywords: amiodarone; beta adrenergic receptor blocking agent; dipeptidyl carboxypeptidase inhibitor, adult; aged; antiarrhythmic activity; article; cardiac resynchronization therapy; cardiomyopathy; correlation analysis; defibrillator; electrocardiogram; electrography; female; follow up; heart ejection fraction; heart ventricle arrhythmia; human; incidence; Kaplan Meier method; major clinical study; male; priority journal; rank sum test; retrospective study; risk assessment; treatment outcome, Adult; Aged; Cardiac Pacing, Artificial; Cardiomyopathy, Dilated; Case-Control Studies; Defibrillators, Implantable; Female; Follow-Up Studies; Humans; Male; Middle Aged; Myocardial Ischemia; Pacemaker, Artificial; Retrospective Studies; Stroke Volume; Survival Analysis; Treatment Outcome; Ventricular Fibrillation
Subjects: WG Cardiovascular System
Depositing User: Librarian Farzaneh Dini
Date Deposited: 19 May 2019 06:46
Last Modified: 19 May 2019 06:46
URI: http://eprints.iums.ac.ir/id/eprint/12114

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