Inappropriate shocks in the subcutaneous ICD: Incidence, predictors and management
Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu klinické zkoušky, časopisecké články, multicentrická studie, pozorovací studie, práce podpořená grantem
PubMed
26026928
DOI
10.1016/j.ijcard.2015.05.135
PII: S0167-5273(15)01198-5
Knihovny.cz E-zdroje
- Klíčová slova
- Hypertrophic cardiomyopathy, Implantable cardioverter-defibrillator, Inappropriate shocks,
- MeSH
- analýza selhání vybavení statistika a číselné údaje MeSH
- defibrilátory implantabilní * škodlivé účinky normy MeSH
- dospělí MeSH
- elektrická defibrilace * škodlivé účinky metody MeSH
- fibrilace síní epidemiologie MeSH
- hypertrofická kardiomyopatie epidemiologie MeSH
- incidence MeSH
- komorová tachykardie terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- proporcionální rizikové modely MeSH
- rizikové faktory MeSH
- senioři MeSH
- standardní péče MeSH
- výsledek terapie MeSH
- zlepšení kvality MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
- Nový Zéland MeSH
BACKGROUND: The entirely subcutaneous implantable cardioverter-defibrillator (S-ICD) eliminates the need for transvenous leads, and therefore has the potential to improve lead-longevity and reduce lead-related complications. The S-ICD has a morphology-based sensing algorithm of which inappropriate shocks have been reported. METHODS: We analyzed the incidence, predictors and management of inappropriate shocks in the EFFORTLESS S-ICD Registry, which collects S-ICD implantation information and follow-up data from clinical centers in Europe and New Zealand. RESULTS: During a follow-up of 21 ± 13 months, 48 out of 581 S-ICD patients (71% male, age 49 ± 18 years) experienced 101 inappropriate shocks (8.3%). The most common cause was cardiac signal oversensing (73%), such as T-wave oversensing. Eighteen shocks (18%) were due to supraventricular tachycardias (SVT), of which 15 occurred in the shock-only zone. Cox-proportional hazard modeling using time-dependent covariates demonstrated that patients with a history of atrial fibrillation (HR 2.4) and patients with hypertrophic cardiomyopathy (HR 4.6) had an increased risk for inappropriate shocks, while programming the primary vector for sensing (from xyphoid to V6) reduced the risk. Reprogramming or optimization of SVT treatment after the first clinical event of inappropriate shock was successful in preventing further inappropriate shocks for cardiac oversensing and SVT events. CONCLUSIONS: Inappropriate shocks, mainly due to cardiac oversensing, occurred in 8.3% of the S-ICD patients. Patients with hypertrophic cardiomyopathy or a history of atrial fibrillation were at increased risk, warranting specific attention for sensing and programming in this population.
Academic Medical Center Amsterdam Netherlands
Boston Scientific St Paul MN USA
Erasmus Medical Centre Rotterdam Netherlands
Na Homolce Hospital Prague Czech Republic
Odense University Hospital Odense Denmark
Russels Hall Hospital Dudley United Kingdom
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