PMID- 16818202
OWN - NLM
STAT- MEDLINE
DCOM- 20061107
LR  - 20161222
IS  - 1547-5271 (Print)
IS  - 1547-5271 (Linking)
VI  - 3
IP  - 7
DP  - 2006 Jul
TI  - Clinical course and long-term follow-up of patients receiving implantable 
      cardioverter-defibrillators.
PG  - 762-8
AB  - BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are increasingly used 
      for primary and secondary prevention of sudden cardiac death. Defibrillators were 
      introduced into clinical practice in 1980. Since that time, factors affecting 
      long-term survival and the natural history of defibrillator patients have not 
      been described. OBJECTIVES: The purpose of this study was to identify clinical 
      predictors of long-term survival in patients receiving ICDs. METHODS: The 
      prognostic value of several clinical variables on the likelihood of survival or 
      appropriate ICD therapy in 1,382 consecutive patients receiving ICDs from 1980 to 
      2003 were evaluated. Data were collected at the time of device implantation, and 
      follow-up was completed through March 2005. RESULTS: In 70 +/- 51 months of 
      follow-up (range 0-282 months), 792 patients died and 421 patients received 
      appropriate ICD therapy at least once. Age, left ventricular ejection fraction, 
      New York Heart Association (NYHA) functional class, Charlson comorbidity index, 
      and antiarrhythmic drug use correlated with mortality. beta-Blocker and 
      angiotensin-converting enzyme inhibitor use was associated with improved 
      survival. Only NYHA functional class correlated with ICD therapy. Patients free 
      of shocks for the first 5 years after ICD implantation had continued risk of 
      arrhythmia recurrence. CONCLUSION: The heart failure characteristics of patients 
      predicted ICD shock probability and survival better than the arrhythmia 
      characteristics or the underlying heart disease. Antiarrhythmic drug use was 
      associated with increased mortality. Beta-blocker and angiotensin-converting 
      enzyme inhibitor use was associated with improved survival. A measurable 
      arrhythmic risk even after prolonged shock-free intervals indicates the need for 
      continued ICD therapy in all patients with appropriate ICD indications.
FAU - Tandri, Harikrishna
AU  - Tandri H
AD  - Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, 
      Maryland, USA.
FAU - Griffith, Lawrence S
AU  - Griffith LS
FAU - Tang, Tania
AU  - Tang T
FAU - Nasir, Khurram
AU  - Nasir K
FAU - Zardkoohi, Omeed
AU  - Zardkoohi O
FAU - Reddy, Chandrasekhar Vasam
AU  - Reddy CV
FAU - Capps, Melissa
AU  - Capps M
FAU - Calkins, Hugh
AU  - Calkins H
FAU - Donahue, J Kevin
AU  - Donahue JK
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20060327
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
CIN - Heart Rhythm. 2006 Jul;3(7):769-70. PMID: 16818203
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Death, Sudden, Cardiac/etiology/*prevention & control
MH  - *Defibrillators, Implantable
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Tachycardia, Ventricular/complications/mortality/*therapy
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2006/07/05 09:00
MHDA- 2006/11/09 09:00
CRDT- 2006/07/05 09:00
PHST- 2005/06/23 00:00 [received]
PHST- 2006/03/18 00:00 [accepted]
PHST- 2006/07/05 09:00 [pubmed]
PHST- 2006/11/09 09:00 [medline]
PHST- 2006/07/05 09:00 [entrez]
AID - S1547-5271(06)01329-4 [pii]
AID - 10.1016/j.hrthm.2006.03.027 [doi]
PST - ppublish
SO  - Heart Rhythm. 2006 Jul;3(7):762-8. doi: 10.1016/j.hrthm.2006.03.027. Epub 2006 
      Mar 27.