PMID- 25754272
OWN - NLM
STAT- MEDLINE
DCOM- 20160222
LR  - 20150602
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 38
IP  - 6
DP  - 2015 Jun
TI  - Outcome of Patients with Advanced Heart Failure Who Receive Device-Based Therapy 
      for Primary Prevention of Sudden Cardiac Death: Insights from the Israeli ICD 
      Registry.
PG  - 738-45
LID - 10.1111/pace.12627 [doi]
AB  - BACKGROUND: Randomized clinical trials have shown conflicting data on the benefit 
      of implantable cardioverter defibrillator (ICD) for primary prevention of sudden 
      cardiac death in patients with more advanced heart failure (HF) symptoms. Using 
      the Israeli ICD Registry data, we sought to examine the effect of HF functional 
      class on the outcome of patients who receive device therapy in a real-world 
      setting. METHODS: The association between HF functional class (categorized as 
      baseline New York Heart Association [NYHA] functional class I and II in [61%] vs 
      class III and IV in [39%]) and clinical outcomes was assessed among 913 patients 
      who received an ICD (n = 514) or a cardiac resynchronization therapy with a 
      defibrillator (CRT-D; n = 399) device and were prospectively followed in the 
      Israeli ICD Registry between July 2011 and June 2013. RESULTS: The risk 
      associated with advanced HF functional class was significantly different in ICD 
      and CRT-D recipients. In the former group, patients with NYHA classes III and IV 
      experienced >3-fold increased risk of HF or death (hazard ratio [HR] = 3.28; P < 
      0.001), whereas among CRT-D recipients the risk was similar between patients with 
      NYHA III/IV and those with less advanced HF symptoms (HR = 0.97 [95% confidence 
      interval (CI) 0.54-1.78]; P = 0.42; P value for NYHA functional class by device 
      type interaction = 0.002). The risk for ventricular arrhythmia (VA) was 
      significantly lower among patients with more advanced NYHA functional class, 
      regardless of device type (overall HR = 0.52; 95% CI 0.33-0.91; P = 0.04). 
      CONCLUSION: Our findings suggest that patients with less advanced HF symptoms 
      experience a greater risk for VA and the development of HF is attenuated in CRT-D 
      recipients with more advanced NYHA functional class.
CI  - (c) 2015 Wiley Periodicals, Inc.
FAU - Suleiman, Mahmoud
AU  - Suleiman M
AD  - Rambam Health Care Campus, Haifa, Israel.
FAU - Goldenberg, Ilan
AU  - Goldenberg I
AD  - Chaim Sheba Medical Center, Tel Hashomer, Israel.
FAU - Samniah, Nimer
AU  - Samniah N
AD  - Beni Tzion Medical Center, Haifa, Israel.
FAU - Rosso, Raphael
AU  - Rosso R
AD  - Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
FAU - Marai, Ibrahim
AU  - Marai I
AD  - Rambam Health Care Campus, Haifa, Israel.
FAU - Pekar, Alexander
AU  - Pekar A
AD  - Ziv Medical Centers, Zefat, Israel.
FAU - Khalameizer, Vladimir
AU  - Khalameizer V
AD  - Barzilai Medical Center, Ashkelon, Israel.
FAU - Militianu, Arie
AU  - Militianu A
AD  - Carmel Medical Center, Haifa, Israel.
FAU - Glikson, Michael
AU  - Glikson M
AD  - Chaim Sheba Medical Center, Tel Hashomer, Israel.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150413
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Death, Sudden, Cardiac/*prevention & control
MH  - *Defibrillators, Implantable
MH  - Female
MH  - Heart Failure/*complications/*therapy
MH  - Humans
MH  - Israel
MH  - Male
MH  - Middle Aged
MH  - *Primary Prevention
MH  - Prospective Studies
MH  - Registries
MH  - Treatment Outcome
OTO - NOTNLM
OT  - cardiac resynchronization
OT  - defibrillator
OT  - heart failure
OT  - outcomes
EDAT- 2015/03/11 06:00
MHDA- 2016/02/24 06:00
CRDT- 2015/03/11 06:00
PHST- 2014/08/18 00:00 [received]
PHST- 2015/02/10 00:00 [revised]
PHST- 2015/03/01 00:00 [accepted]
PHST- 2015/03/11 06:00 [entrez]
PHST- 2015/03/11 06:00 [pubmed]
PHST- 2016/02/24 06:00 [medline]
AID - 10.1111/pace.12627 [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2015 Jun;38(6):738-45. doi: 10.1111/pace.12627. Epub 
      2015 Apr 13.