Ongoing Risk of Ventricular Arrhythmias and All-Cause Mortality at Implantable Cardioverter Defibrillator Generator Change
| العنوان: | Ongoing Risk of Ventricular Arrhythmias and All-Cause Mortality at Implantable Cardioverter Defibrillator Generator Change |
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| المؤلفون: | Hirad Yarmohammadi, David Martin, Peter Hoffmeister, Sebhat A. Erqou, Adelqui Peralta, Matthew F Yuyun, Justin B. Echouffo-Tcheugui, Jagmeet P. Singh, Jacob Joseph |
| المصدر: | Circulation: Arrhythmia and Electrophysiology. 14 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, medicine.medical_treatment, Electric Countershock, Action Potentials, 030204 cardiovascular system & hematology, Risk Assessment, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, Heart Rate, Risk Factors, Physiology (medical), Internal medicine, medicine, Humans, 030212 general & internal medicine, Device Removal, Aged, Generator (computer programming), business.industry, Incidence, Arrhythmias, Cardiac, Stroke Volume, Middle Aged, Implantable cardioverter-defibrillator, Defibrillators, Implantable, Death, Sudden, Cardiac, Treatment Outcome, Meta-analysis, Relative risk, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, All cause mortality |
| الوصف: | Background: Uncertainty still surrounds implantable cardioverter defibrillator (ICD) generator change at time of elective replacement indicator, in primary prevention patients with improved left ventricular ejection fraction (LVEF) beyond guideline recommendations or without prior appropriate ICD therapies. Methods: We conducted a meta-analysis of studies assessing the risk of appropriate ICD therapies and all-cause mortality after generator change in patients with improved LVEF>35% versus unimproved LVEF≤35% or patients without versus with prior appropriate ICD therapies during the life of their first ICD generator. A systematic electronic search of PubMed, EMBASE, and Cochrane Library databases until December 31, 2019 was performed. Estimates were combined using random-effects model meta-analyses. Results: In 15 studies that included 29 730 patients, 25.3% had LVEF improvement >35% at time of generator change. The pooled annual incidence of appropriate ICD therapies was significantly lower in those with improved LVEF, compared with patients with unimproved LVEF: 4.6% versus 10.7%; risk ratio, 0.50 (95% CI, 0.36–0.68), P P P =0.750). In 8 studies (N=27 209), the pooled incidence of ventricular arrhythmia was significantly lower in patients without prior ICD therapies (3.9% per annum), compared with those with prior ICD therapies (12.5 % per annum), risk ratio of 0.37 (95% CI, 0.33–0.41), P Conclusions: There was significant reduction in risk of ventricular arrhythmias and mortality in patients with improved versus unimproved LVEF or those who received versus those who did not receive appropriate ICD therapies during the life of their first ICD generator. However, we found a substantial residual outcome risk in these groups of patients. |
| تدمد: | 1941-3084 1941-3149 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::46f05197e3e72f2011c4c07f65b8793a https://doi.org/10.1161/circep.120.009139 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....46f05197e3e72f2011c4c07f65b8793a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19413084 19413149 |
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