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Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Medicine / Faculty of Medicine >
Peer-reviewed Journal Articles, etc >
Predictors and Proarrhythmic Consequences of Inappropriate Implantable Cardioverter-Defibrillator Therapy
| Title: | Predictors and Proarrhythmic Consequences of Inappropriate Implantable Cardioverter-Defibrillator Therapy |
| Authors: | Tenma, Taro Browse this author | | Yokoshiki, Hisashi Browse this author →KAKEN DB | | Mizukami, Kazuya Browse this author | | Mitsuyama, Hirofumi Browse this author | | Watanabe, Masaya Browse this author | | Sasaki, Ryo Browse this author | | Maeno, Motoki Browse this author | | Matsui, Yoshiro Browse this author →KAKEN DB | | Tsutsui, Hiroyuki Browse this author →KAKEN DB |
| Keywords: | Antitachycardia pacing | | Implantable cardioverter-defibrillator | | Inappropriate shock | | Paroxysmal atrial fibrillation | | Proarrhythmia |
| Issue Date: | 25-Aug-2015 |
| Publisher: | The Japanese Circulation Society |
| Journal Title: | Circulation Journal |
| Volume: | 79 |
| Issue: | 9 |
| Start Page: | 1920 |
| End Page: | 1927 |
| Publisher DOI: | 10.1253/circj.CJ-15-0306 |
| PMID: | 26104029 |
| Abstract: | Background: Despite the benefits of implantable cardioverter-defibrillator (ICD) therapy, inappropriate shocks can lead to multiple adverse effects. The aim of this study was to clarify the predictors of inappropriate ICD shocks and their proarrhythmic consequences. Methods and Results: We retrospectively studied 316 consecutive patients who underwent ICD implantation from December 2000 to December 2011. Of them, 70 (22%) experienced inappropriate ICD shocks without proarrhythmia requiring some intervention; 2 patients (0.6%) had proarrhythmic inappropriate ICD therapy by antitachycardia pacing (ATP), thereby calculated to be 0.18% of patients per year. However, they did not have syncope from this inappropriate ATP. Multivariate analysis identified younger age (≤56 years: hazard ratio [HR] 1.68, 95% confidence interval [CI] 1.02-2.77, P=0.043), paroxysmal atrial fibrillation (HR 3.00, 95% CI 1.64-5.31, P=0.0002), stroke (HR 2.23, 95% CI 1.11-4.47, P=0.024), and no diuretic use (HR 1.72, 95% CI 1.03-2.93, P=0.039) as independent predictors of the occurrence of inappropriate ICD shocks. Conclusions: Young age, paroxysmal atrial fibrillation, stroke, and no use of diuretics were independently associated with inappropriate ICD shocks. Proarrhythmic inappropriate ICD therapy was observed with an annual incidence of 0.18% by ATP. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/71892 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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Submitter: 天満 太郎
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