دورية أكاديمية
Heart rate turbulence predicts ICD-resistant mortality in ischaemic heart disease.
| العنوان: | Heart rate turbulence predicts ICD-resistant mortality in ischaemic heart disease. |
|---|---|
| المؤلفون: | Marynissen T; Department of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium., Floré V; Department of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium., Heidbuchel H; Department of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium., Nuyens D; Department of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium., Ector J; Department of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium., Willems R; Department of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium rik.willems@uzleuven.be. |
| المصدر: | Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2014 Jul; Vol. 16 (7), pp. 1069-77. Date of Electronic Publication: 2013 Nov 06. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 100883649 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-2092 (Electronic) Linking ISSN: 10995129 NLM ISO Abbreviation: Europace Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2006- : Oxford : Oxford University Press Original Publication: London ; Philadelphia : Saunders, c1999- |
| مواضيع طبية MeSH: | Defibrillators, Implantable* , Heart Rate*, Electric Countershock/*instrumentation , Myocardial Ischemia/*complications , Tachycardia, Ventricular/*therapy, Aged ; Body Mass Index ; Electric Countershock/adverse effects ; Electric Countershock/mortality ; Electrocardiography, Ambulatory ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Ischemia/diagnosis ; Myocardial Ischemia/mortality ; Myocardial Ischemia/physiopathology ; Patient Selection ; Predictive Value of Tests ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stroke Volume ; Tachycardia, Ventricular/diagnosis ; Tachycardia, Ventricular/etiology ; Tachycardia, Ventricular/mortality ; Time Factors ; Treatment Failure ; Ventricular Function, Left |
| مستخلص: | Aims: In high-risk patients, implantable cardioverter-defibrillators (ICDs) can convert the mode of death from arrhythmic to pump failure death. Therefore, we introduced the concept of 'ICD-resistant mortality' (IRM), defined as death (a) without previous appropriate ICD intervention (AI), (b) within 1 month after the first AI, or (c) within 1 year after the initial ICD implantation. Implantable cardioverter-defibrillator implantation in patients with a high risk of IRM should be avoided. Methods and Results: Implantable cardioverter-defibrillator patients with ischaemic heart disease were included if a digitized 24 h Holter was available pre-implantation. Demographic, electrocardiographic, echocardiographic, and 24 h Holter risk factors were collected at device implantation. The primary endpoint was IRM. Cox regression analyses were used to test the association between predictors and outcome. We included 130 patients, with a mean left ventricular ejection fraction (LVEF) of 33.6 ± 10.3%. During a follow-up of 52 ± 31 months, 33 patients died. There were 21 cases of IRM. Heart rate turbulence (HRT) was the only Holter parameter associated with IRM and total mortality. A higher New York Heart Association (NYHA) class and a lower body mass index were the strongest predictors of IRM. Left ventricular ejection fraction predicted IRM on univariate analysis, and was the strongest predictor of total mortality. The only parameter that predicted AI was non-sustained ventricular tachycardia. Conclusion: Implantable cardioverter-defibrillator implantation based on NYHA class and LVEF leads to selection of patients with a higher risk of IRM and death. Heart rate turbulence may have added value for the identification of poor candidates for ICD therapy. Available Holter parameters seem limited in their ability to predict AI. (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013. For permissions please email: journals.permissions@oup.com.) |
| فهرسة مساهمة: | Keywords: Heart rate turbulence; ICD; Ischaemic heart disease; Non-invasive risk stratification; Sudden cardiac death |
| تواريخ الأحداث: | Date Created: 20131108 Date Completed: 20150219 Latest Revision: 20140626 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1093/europace/eut303 |
| PMID: | 24196450 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1532-2092 |
|---|---|
| DOI: | 10.1093/europace/eut303 |