Abstract
The aim of this study was to evaluate ventricular arrhythmias occurring in recipients of the InSync ICD for the primary and secondary prevention of sudden death. The InSync ICD was implanted in 142 patients (128 men; mean age 65 ± 10 years) with heart failure (mean NYHA functional Class 3.0 ± 0.7) and wide QRS (mean 159 ± 33 ms). The underlying etiology was ischemic in 55%, idiopathic in 33%, and valvular or hypertensive cardiomyopathy in 12% of patients. The numbers of arrhythmic episodes/100 patient-months was computed with their 95% CI, assuming a Poisson distribution. Implants were performed in 48 (34%) patients who did not have an ACC/AHA guidelines Class I indication for ICD therapy. A total of 104 patients were compliant for follow-up visits. During a 9-month median (range 0.1-24) follow-up of 104 compliant patients, 19 experienced a total of 94 ventricular arrhythmias, all successfully interrupted or selfterminated, with a median number of two separate episodes, corresponding to a rate of 10 episodes/100 person-month (95% CI 8-12). A rate of 12 episodes/100 person-months (95% CI 10-15) was measured in the subgroup of patients with ACC/AHA class I indications, versus two episodes/100 person-months (95% CI 1-5) in the remainder of the population. Among 12 deaths, 9 were due to heart failure, I to a noncardiovascular cause, and 2 to unknown causes. The implantation of ICD in heart failure patients has been prominently extended to primary prevention. Patients without standard ICD indications experienced life-threatening arrhythmic events. The impact of ICD combined with cardiac resynchronization therapy on arrhythmic profile, mortality, and costs in this subgroup of patients need to be more precisely studied, with a particular focus on the various types of underlying heart disease.
| Original language | English |
|---|---|
| Pages (from-to) | 148-151 |
| Number of pages | 4 |
| Journal | PACE - Pacing and Clinical Electrophysiology |
| Volume | 26 |
| Issue number | 1 II |
| Publication status | Published - Jan 1 2003 |
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Keywords
- Cardiac resynchronization therapy
- Heart failure
- Implantable cardioverter defibrillator
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Cardiac resynchronization and implantable cardioverter defibrillator therapy : Preliminary results from the InSync implantable cardioverter defibrillator italian registry. / Gasparini, Maurizio; Lunati, Maurizio; Bocchiardo, Mario; Mantica, Massimo; Gronda, Edoardo; Frigerio, Maria; Caponi, Domenico; Carboni, Angelo; Boriani, Giuseppe; Zanotto, Gabriele; Antonio Ravazzi, Pier; Curnis, Antonio; Puglisi, Andrea; Klersy, Catherine; Vicini, Ilaria; Cavaglià, Sergio.
In: PACE - Pacing and Clinical Electrophysiology, Vol. 26, No. 1 II, 01.01.2003, p. 148-151.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cardiac resynchronization and implantable cardioverter defibrillator therapy
T2 - Preliminary results from the InSync implantable cardioverter defibrillator italian registry
AU - Gasparini, Maurizio
AU - Lunati, Maurizio
AU - Bocchiardo, Mario
AU - Mantica, Massimo
AU - Gronda, Edoardo
AU - Frigerio, Maria
AU - Caponi, Domenico
AU - Carboni, Angelo
AU - Boriani, Giuseppe
AU - Zanotto, Gabriele
AU - Antonio Ravazzi, Pier
AU - Curnis, Antonio
AU - Puglisi, Andrea
AU - Klersy, Catherine
AU - Vicini, Ilaria
AU - Cavaglià, Sergio
PY - 2003/1/1
Y1 - 2003/1/1
N2 - The aim of this study was to evaluate ventricular arrhythmias occurring in recipients of the InSync ICD for the primary and secondary prevention of sudden death. The InSync ICD was implanted in 142 patients (128 men; mean age 65 ± 10 years) with heart failure (mean NYHA functional Class 3.0 ± 0.7) and wide QRS (mean 159 ± 33 ms). The underlying etiology was ischemic in 55%, idiopathic in 33%, and valvular or hypertensive cardiomyopathy in 12% of patients. The numbers of arrhythmic episodes/100 patient-months was computed with their 95% CI, assuming a Poisson distribution. Implants were performed in 48 (34%) patients who did not have an ACC/AHA guidelines Class I indication for ICD therapy. A total of 104 patients were compliant for follow-up visits. During a 9-month median (range 0.1-24) follow-up of 104 compliant patients, 19 experienced a total of 94 ventricular arrhythmias, all successfully interrupted or selfterminated, with a median number of two separate episodes, corresponding to a rate of 10 episodes/100 person-month (95% CI 8-12). A rate of 12 episodes/100 person-months (95% CI 10-15) was measured in the subgroup of patients with ACC/AHA class I indications, versus two episodes/100 person-months (95% CI 1-5) in the remainder of the population. Among 12 deaths, 9 were due to heart failure, I to a noncardiovascular cause, and 2 to unknown causes. The implantation of ICD in heart failure patients has been prominently extended to primary prevention. Patients without standard ICD indications experienced life-threatening arrhythmic events. The impact of ICD combined with cardiac resynchronization therapy on arrhythmic profile, mortality, and costs in this subgroup of patients need to be more precisely studied, with a particular focus on the various types of underlying heart disease.
AB - The aim of this study was to evaluate ventricular arrhythmias occurring in recipients of the InSync ICD for the primary and secondary prevention of sudden death. The InSync ICD was implanted in 142 patients (128 men; mean age 65 ± 10 years) with heart failure (mean NYHA functional Class 3.0 ± 0.7) and wide QRS (mean 159 ± 33 ms). The underlying etiology was ischemic in 55%, idiopathic in 33%, and valvular or hypertensive cardiomyopathy in 12% of patients. The numbers of arrhythmic episodes/100 patient-months was computed with their 95% CI, assuming a Poisson distribution. Implants were performed in 48 (34%) patients who did not have an ACC/AHA guidelines Class I indication for ICD therapy. A total of 104 patients were compliant for follow-up visits. During a 9-month median (range 0.1-24) follow-up of 104 compliant patients, 19 experienced a total of 94 ventricular arrhythmias, all successfully interrupted or selfterminated, with a median number of two separate episodes, corresponding to a rate of 10 episodes/100 person-month (95% CI 8-12). A rate of 12 episodes/100 person-months (95% CI 10-15) was measured in the subgroup of patients with ACC/AHA class I indications, versus two episodes/100 person-months (95% CI 1-5) in the remainder of the population. Among 12 deaths, 9 were due to heart failure, I to a noncardiovascular cause, and 2 to unknown causes. The implantation of ICD in heart failure patients has been prominently extended to primary prevention. Patients without standard ICD indications experienced life-threatening arrhythmic events. The impact of ICD combined with cardiac resynchronization therapy on arrhythmic profile, mortality, and costs in this subgroup of patients need to be more precisely studied, with a particular focus on the various types of underlying heart disease.
KW - Cardiac resynchronization therapy
KW - Heart failure
KW - Implantable cardioverter defibrillator
UR - http://www.scopus.com/inward/record.url?scp=0346665533&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0346665533&partnerID=8YFLogxK
M3 - Article
C2 - 12687801
AN - SCOPUS:0346665533
VL - 26
SP - 148
EP - 151
JO - PACE - Pacing and Clinical Electrophysiology
JF - PACE - Pacing and Clinical Electrophysiology
SN - 0147-8389
IS - 1 II
ER -