PMID- 16461053
OWN - NLM
STAT- MEDLINE
DCOM- 20060322
LR  - 20071115
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 97
IP  - 4
DP  - 2006 Feb 15
TI  - Relation of advanced heart failure symptoms to risk of inappropriate 
      defibrillator shocks.
PG  - 544-6
AB  - Inappropriate implantable cardioverter-defibrillator (ICD) shocks continue to be 
      a major source of distress to patients and a drain on the health care system. 
      Expanding indications for ICD implantation include a large portion of patients 
      with heart failure. This study investigated the relation between inappropriate 
      ICD shocks and the severity of heart failure symptoms. Predictors of the time to 
      first inappropriate ICD therapy were investigated in 230 consecutive patients 
      implanted in 2001 and 2002. Thirty-two patients received 42 inappropriate shocks 
      during a median follow-up of 501 days. Inappropriate shocks were due to atrial 
      fibrillation (AF) or tachycardia (n = 31), other supraventricular tachycardias 
      (n= 6), sinus tachycardia (n = 3), and noise or double counting (n = 2). The time 
      to first inappropriate ICD shock was earliest in patients with advanced classes 
      of heart failure (1- and 2-year shock-free survival of 79% and 70% for patients 
      in New York Heart Association [NYHA] class III or IV vs 92% and 88% for patients 
      in NYHA class I or II, respectively, p = 0.02). After correcting for age, gender, 
      the presence of coronary artery disease, the presence of AF, the use of beta 
      blockers, and indication for ICD implantation in a Cox regression model, advanced 
      heart failure (NYHA class III or IV) remained an independent predictor of first 
      inappropriate ICD shocks (hazard ratio 2.7, p = 0.01). Other predictors of the 
      time to first inappropriate ICD shock included the presence of AF as the baseline 
      rhythm at the time of the ICD implantation and the absence of coronary disease. 
      In conclusion, inappropriate ICD shocks are predominantly due to AF. Advanced 
      heart failure is an independent predictor of the time to first inappropriate ICD 
      shocks. The effect of ICD programming and antiarrhythmic drug therapy on the 
      incidence of inappropriate shocks deserves further investigation.
FAU - Hreybe, Haitham
AU  - Hreybe H
AD  - University of Pittsburgh, Pennsylvania, USA.
FAU - Ezzeddine, Rana
AU  - Ezzeddine R
FAU - Barrington, William
AU  - Barrington W
FAU - Bazaz, Raveen
AU  - Bazaz R
FAU - Jain, Sandeep
AU  - Jain S
FAU - Ngwu, Ogundu
AU  - Ngwu O
FAU - Saba, Samir
AU  - Saba S
LA  - eng
PT  - Journal Article
DEP - 20060104
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Atrial Fibrillation/complications
MH  - *Defibrillators, Implantable
MH  - Equipment Failure
MH  - Female
MH  - Heart Failure/complications/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Tachycardia/complications
MH  - Tachycardia, Sinus/complications
MH  - Tachycardia, Supraventricular/complications
EDAT- 2006/02/08 09:00
MHDA- 2006/03/23 09:00
CRDT- 2006/02/08 09:00
PHST- 2005/05/01 00:00 [received]
PHST- 2005/08/29 00:00 [revised]
PHST- 2005/08/29 00:00 [accepted]
PHST- 2006/02/08 09:00 [pubmed]
PHST- 2006/03/23 09:00 [medline]
PHST- 2006/02/08 09:00 [entrez]
AID - S0002-9149(05)01907-7 [pii]
AID - 10.1016/j.amjcard.2005.08.074 [doi]
PST - ppublish
SO  - Am J Cardiol. 2006 Feb 15;97(4):544-6. doi: 10.1016/j.amjcard.2005.08.074. Epub 
      2006 Jan 4.