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Relation between total shock energy and mortality in patients with implantable cardioverter-defibrillator

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Title: Relation between total shock energy and mortality in patients with implantable cardioverter-defibrillator
Authors: Tenma, Taro Browse this author
Yokoshiki, Hisashi Browse this author →KAKEN DB
Mitsuyama, Hirofumi Browse this author
Watanabe, Masaya Browse this author
Mizukami, Kazuya Browse this author
Kamada, Rui Browse this author
Takahashi, Masayuki Browse this author
Sasaki, Ryo Browse this author
Maeno, Motoki Browse this author
Okamoto, Kaori Browse this author
Chiba, Yuki Browse this author
Anzai, Toshihisa Browse this author
Keywords: Total shock energy
Implantable cardioverter-defibrillator
Mortality
Shock accumulation
Low left ventricular ejection fraction
Atrial fibrillation
Issue Date: 15-May-2018
Publisher: Elsevier
Journal Title: International journal of cardiology
Volume: 259
Start Page: 94
End Page: 99
Publisher DOI: 10.1016/j.ijcard.2018.02.063
Abstract: Background: Implantable Cardioverter-Defibrillator (ICD) shocks have been associated with mortality. However, no study has examined the relation between total shock energy and mortality. The aim of this study is to assess the association of total shock energy with mortality, and to determine the patients who are at risk of this association. Methods: Data from 316 consecutive patients who underwent initial ICD implantation in our hospital between 2000 and 2011 were retrospectively studied. We collected shock energy for 3 years from the ICD implantation, and determined the relation of shock energy on mortality after adjusting confounding factors. Results: Eighty-seven ICD recipients experienced shock(s) within 3 years from ICD implantation and 43 patients had died during the follow-up. The amount of shock energy was significantly associated with all-cause death [adjusted hazard ratio (HR) 1.26 (per 100 joule increase), p < 0.01] and tended to be associated with cardiac death (adjusted HR 1.30, p = 0.08). The survival rate of patients with high shock energy accumulation (>= 182 joule) was lower (p = 0.05), as compared to low shock energy accumulation (<182 joule), likewise to no shock. Besides, the relation between high shock energy accumulation and all-cause death was remarkable in the patients with low left ventricular ejection fraction (LVEF <= 40%) or atrial fibrillation (AF). Conclusions: Increase of shock energywas related tomortality in ICD recipients. This relation was evident in patients with low LVEF or AF.
Rights: © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
http://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article (author version)
URI: http://hdl.handle.net/2115/74003
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)

Submitter: 天満 太郎

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