1
|
Ueda N, Noda T, Kanaoka K, Miyazaki Y, Wakamiya A, Nakajima K, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Aiba T, Kanzaki H, Izumi C, Noguchi T, Yasuda S, Kusano K. Clinical Significance of Atrial Tachyarrhythmia Duration for Ventricular Arrhythmia in Patients With Cardiac Resynchronization Therapy. Circ J 2024; 88:1138-1146. [PMID: 38057103 DOI: 10.1253/circj.cj-23-0547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
BACKGROUND Atrial tachyarrhythmias (ATAs) are reportedly associated with ventricular arrhythmias (VAs). However, little is known about the association between ATA duration and the risk of VA. We investigated the relationship between ATA duration and subsequent VA in patients with a cardiac resynchronization therapy defibrillator (CRT-D). METHODS AND RESULTS We investigated associations between the longest ATA duration during the first year after cardiac resynchronization therapy (CRT) implantation and VA and VA relevant to ATA (VAATA) in 160 CRT-D patients. ATAs occurred in 63 patients in the first year. During a median follow-up of 925 days from 1 year after CRT implantation, 40 patients experienced 483 VAs. Kaplan-Meier analysis showed a significantly higher risk of VA in patients with than without ATA in the first year (log rank P=0.0057). Hazard ratios (HR) of VA (HR 2.36, 2.10, and 3.04 for ATA >30s, >6 min and >24 h, respectively) and only VAATA (HR 4.50, 5.59, and 11.79 for ATA >30s, >6 min and >24 h, respectively) increased according to the duration of ATA. In multivariate analysis, ATA >24 h was an independent predictor of subsequent VA (HR 2.42; P=0.02). CONCLUSIONS Patients with ATA >24 h in the first year after CRT had a higher risk of subsequent VA and VAATA. The risk of VA, including VAATA, increased with the longest ATA duration.
Collapse
Affiliation(s)
- Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Koshiro Kanaoka
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | - Yuichiro Miyazaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hideaki Kanzaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| |
Collapse
|
2
|
Dewidar O, Birnie D, Podinic I, Welch V, Wells GA. Sex differences in CRT device implantation rates, efficacy, and complications following implantation: protocol for a systematic review and meta-analysis of cohort studies. Syst Rev 2021; 10:210. [PMID: 34301313 PMCID: PMC8305491 DOI: 10.1186/s13643-021-01746-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 06/15/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION There is abundant evidence for sex differences in the diagnosis, implantation, and outcomes for cardiac resynchronization therapy (CRT) devices. Controversial data suggesting women are less likely to receive the device regardless of the greater benefit. The aim of this review is to assess sex differences in the implantation rate, clinical effectiveness, and safety of patients receiving CRT devices. METHODS We will conduct a systematic literature search of MEDLINE, Embase, and Web of Science to identify cohort studies that meet our eligibility criteria. Title and full text screening will be conducted in duplicate independently. Eligible studies report clinical effectiveness or safety of patients receiving CRT device while providing sex-disaggregated data. Implantation rate will be extracted from the baseline characteristics tables of the studies. The effectiveness outcomes include the following: all-cause death, hospitalization, peak oxygen consumption (pVO2), quality of life (QoL), 6-min walk test, NYHA class reduction, LVEF, and heart failure hospitalization. The complication outcomes include the following: contrast-induced nephropathy, pneumothorax, pocket-related hematoma, pericardial tamponade, phrenic nerve stimulation, device infection, death, pulmonary edema, electrical storm, cardiogenic shock, and hypotension requiring resuscitation. Description of included studies will be reported in detail and outcomes will be meta-analyzed and presented using forest plots when feasible. Risk of bias will be assessed using the Newcastle-Ottawa Scale (NOS) by two review authors independently. GRADE approach will be used to assess the certainty of evidence. DISCUSSION The aim of this review is to determine the presence of differences in CRT implantation between women and men as well as differences in clinical effectiveness and safety of CRT after device implantation. Results from this systematic review will provide important insights into sex differences in CRT devices that could contribute to the development of sex-specific recommendations and inform policy. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020204804.
Collapse
Affiliation(s)
- Omar Dewidar
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario, K1G 5Z3, Canada. .,Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario, K1R 6M1, Canada.
| | - David Birnie
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, Ontario, K1Y 4W7, Canada
| | - Irina Podinic
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario, K1G 5Z3, Canada
| | - Vivian Welch
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario, K1G 5Z3, Canada.,Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario, K1R 6M1, Canada
| | - George A Wells
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario, K1G 5Z3, Canada.,Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, Ontario, K1Y 4W7, Canada
| |
Collapse
|
3
|
Maruyama M, Yasuoka R, Nagano T, Nakazawa G, Noda T, Nitta T, Aizawa Y, Ohe T, Kurita T. Impact of atrial fibrillation/flutter on outcomes of patients with implantable cardioverter defibrillators: A sub-analysis of the Nippon Storm study. J Cardiol 2021; 78:244-249. [PMID: 33941429 DOI: 10.1016/j.jjcc.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Implantable cardioverter-defibrillator and cardiac resynchronization therapy using a defibrillator (ICD/CRT-D) are established means of reducing mortality due to ventricular arrhythmia. Although atrial fibrillation/flutter (AF) is the most common cardiac arrhythmia in patients with heart disease, the impact of AF on the prognosis of patients with ICD/CRT-D remains controversial. METHODS AND RESULTS We analyzed data from the Nippon Storm Study, a prospective observational study of 1570 patients that was conducted at 48 Japanese ICD centers. We allocated 1549 participants to AF and non-AF groups, compared their clinical data at the time of enrollment, and monitored the incidences of mortality, hospitalization, and appropriate and inappropriate ICD/CRT-D therapy during a median 28 months. When the AF (n = 257, 16.6%) and non-AF-(n = 1292, 83.4%) groups were compared, the AF group was older (67.7 vs. 61.4 years; p<0.0001), and had lower left ventricular ejection fraction (38.0 ± 17.0% vs. 43.5 ± 18.9%; p<0.0001). During follow up, mortality was significantly higher in the AF than the non-AF group (p<0.0001). In multivariate analysis, AF was significantly associated with all-cause mortality [p = 0.013; hazard ratio (HR)=1.62]. Inappropriate ICD/CRT-D therapy occurred in 40/257 patients (15.6%) and AF was associated with a higher prevalence of inappropriate ICD/CRT-D therapy (p<0.0001; HR=2.25). CONCLUSION The presence of AF at ICD/CRT-D implantation carries subsequent independent risks of 1.62-fold for death and 2.25-fold for inappropriate therapy.
Collapse
Affiliation(s)
- Masahiro Maruyama
- Department of Internal Medicine, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Ryobun Yasuoka
- Department of Internal Medicine, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Tomoya Nagano
- Department of Internal Medicine, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Gaku Nakazawa
- Department of Internal Medicine, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takashi Nitta
- Department of Cardiovascular Surgery, Nippon Medical School, Tokyou, Japan
| | - Yoshifusa Aizawa
- Department of Research and Development, Tachikawa Medical Center, Tachikawa, Japan
| | - Tohru Ohe
- Okayama City Hospital, Okayama, Japan
| | - Takashi Kurita
- Department of Internal Medicine, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan.
| |
Collapse
|
4
|
Shakibfar S, Yazdchi M, Aliakbaryhosseinabadi S. Predicting Electrical Storm Using Episodes' Parameters from ICD Recorded Data. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:4885-4888. [PMID: 31946955 DOI: 10.1109/embc.2019.8857720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Electrical storm (ES) is a life-threatening heart condition for patients with implantable cardioverter defibrillators (ICDs). ICD patients experienced episodes are at higher risk for ES. However, predicting ES using previous episodes' parameters recorded by ICDs have never been developed. This study aims to predict ES using machine learning models based on ICD remote monitoring-summaries during episodes in the anonymized large number of patients. Episode ICD-summaries from 16,022 patients were used to construct and evaluate two models, logistic regression and random forest, for predicting the short-term risk of ES. Episode parameters in this study included the total number of sustained episodes, shocks delivered and the cycle length parameters. The models evaluated on the data sections not used for model development. Random forest performed significantly better than logistic regression (P <; 0.01), achieving a test accuracy of 0.99 and an Area Under an ROC Curve (AUC) of 0.93 (vs. an accuracy of 0.98 and an AUC of 0.90). The total number of previous sustained episodes was the most relevant variables in the both models.
Collapse
|
5
|
Gadula-Gacek E, Tajstra M, Gąsior M. Electrical storm - still an extremely poor prognosis. Do these acute states of life-threatening arrhythmias require a multidirectional approach from the start? ADVANCES IN INTERVENTIONAL CARDIOLOGY 2019; 15:1-12. [PMID: 31043979 PMCID: PMC6488832 DOI: 10.5114/aic.2019.83769] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 10/13/2018] [Indexed: 11/23/2022] Open
Abstract
Electrical storm (ES) is a state of electrical instability of the heart manifesting as multiple and potentially lethal recurring ventricular arrhythmias such as ventricular tachycardia or ventricular fibrillation. This definition is not related to the condition of each patient, who can present from asymptomatic to unconscious and in deep cardiogenic shock. Most patients affected by ES have heart failure (HF) of ischaemic origin. Ischaemia, exacerbation of HF, low ejection fraction, previous ventricular arrhythmias, infection or electrolyte disturbances together with other factors, or a few factors combined, may result in ES. The prognosis of ES survivors is very poor, with 1-year mortality exceeding 40%, which should draw attention to this group of patients as one of extremely high risk. The number of patients with cardioverter-defibrillators is increasing and so is the number of patients suffering from ES. Therefore, each patient should be supported with tailored therapy, and not only restricted to pharmacotherapy or ablation procedures. This paper was written to analyse the most frequent causes of ES and prompt the most appropriate clinical pathways and possibilities, underlining the need for a comprehensive invasive approach to diagnosis, treatment and circulatory stabilization in addition to adequate pharmacotherapy. This approach might help to reduce the mortality rate in this group of patients and improve the prognosis.
Collapse
Affiliation(s)
- Elżbieta Gadula-Gacek
- 3 Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Disease in Zabrze, Poland
| | - Mateusz Tajstra
- 3 Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Disease in Zabrze, Poland
| | - Mariusz Gąsior
- 3 Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Disease in Zabrze, Poland
| |
Collapse
|
6
|
Osman M, Ahmed A, Alzubi H, Kheiri B, Osman K, Barbarawi M, Ríos-Bedoya CF, Bachuwa G, Hassan M. Association between changes in the intrathoracic impedance and ventricular arrhythmias in patients with heart failure. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2018; 41:1577-1582. [PMID: 30362185 DOI: 10.1111/pace.13535] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 07/21/2018] [Accepted: 08/04/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Ventricular arrhythmias (VAs) are independently related to mortality risk in patients with heart failure (HF). The wide availability of implantable cardioverter defibrillators and cardiac resynchronization therapy devices now offers an opportunity to clinically correlate the two disease processes. We hypothesized that there is an association between changes in the intrathoracic impedance and episodes of VA. METHODS Nonconcurrent prospective study of adults (age >20 years) with known HF with reduced ejection fraction (<35%). The OptiVol threshold was categorized as follows: 0-30 Ω-days, 31-60 Ω-days, 61-90 Ω-days, 91-120 Ω-days, and >120 Ω-days. Patients with OptiVol values at 0-30 Ω-days were used as the reference group. Receiver operating characteristic analysis was used to estimate the sensitivity and specificity at each threshold. RESULTS Of the 87 eligible patients, 65.5% were males. The mean age of the sample was 73.3 years (±12.7). Compared to patients in the 0-30 Ω-days category, those in the 31-60, 61-90, 91-120, and >120 Ω-days groups had, on average, 1.48, 1.64, 2.24, and 1.6 more VAs, respectively (P = 0.002, 0.009, 0.010 and 0.009, respectively). The sensitivity and specificity of each threshold were as follows: 82.6% and 61.7% at 31-60 Ω-days, 43.5% and 78.3% at 61-90 Ω-days, 30.4% and 85.0% at 91-120 Ω-days, and 21.7% and 88.3% at >121 Ω-days. CONCLUSION Our study found a significant positive relationship between changes in intrathoracic impedance and episodes of VAs in patients with HF.
Collapse
Affiliation(s)
- Mohammed Osman
- Internal Medicine Department, Hurley Medical Center/Michigan State University, Flint, MI, USA.,Division of Cardiology, Department of Medicine, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Azza Ahmed
- Internal Medicine Department, Hurley Medical Center/Michigan State University, Flint, MI, USA
| | - Hussam Alzubi
- Internal Medicine Department, Hurley Medical Center/Michigan State University, Flint, MI, USA
| | - Babikir Kheiri
- Internal Medicine Department, Hurley Medical Center/Michigan State University, Flint, MI, USA
| | - Khansa Osman
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Mahmoud Barbarawi
- Internal Medicine Department, Hurley Medical Center/Michigan State University, Flint, MI, USA
| | - Carlos F Ríos-Bedoya
- Internal Medicine Department, Hurley Medical Center/Michigan State University, Flint, MI, USA
| | - Ghassan Bachuwa
- Internal Medicine Department, Hurley Medical Center/Michigan State University, Flint, MI, USA
| | - Mustafa Hassan
- Internal Medicine Department, Hurley Medical Center/Michigan State University, Flint, MI, USA
| |
Collapse
|
7
|
Noda T, Kurita T, Nitta T, Chiba Y, Furushima H, Matsumoto N, Toyoshima T, Shimizu A, Mitamura H, Okumura K, Ohe T, Aizawa Y. Significant impact of electrical storm on mortality in patients with structural heart disease and an implantable cardiac defibrillator. Int J Cardiol 2018; 255:85-91. [DOI: 10.1016/j.ijcard.2017.11.077] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/20/2017] [Accepted: 11/22/2017] [Indexed: 10/18/2022]
|
8
|
YIN KANG, DING LIGANG, HUA WEI, ZHANG SHU. Electrical Storm in ICD Recipients with Arrhythmogenic Right Ventricular Cardiomyopathy. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2017; 40:683-692. [DOI: 10.1111/pace.13070] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 02/20/2017] [Accepted: 02/24/2017] [Indexed: 02/06/2023]
Affiliation(s)
- KANG YIN
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing P. R. China
| | - LIGANG DING
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing P. R. China
| | - WEI HUA
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing P. R. China
| | - SHU ZHANG
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing P. R. China
| |
Collapse
|
9
|
Li LI, Zhou YL, Zhang XJ, Wang HT. Successful treatment of cardiac electrical storm in dilated cardiomyopathy using esmolol: A case report. Exp Ther Med 2016; 12:107-110. [PMID: 27347024 PMCID: PMC4906816 DOI: 10.3892/etm.2016.3281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 03/18/2016] [Indexed: 01/03/2023] Open
Abstract
The present study reports a case of electrical storm occurring in a 43-year-old woman with dilated cardiomyopathy. The patient suffered from a cardiac electrical storm, with 98 episodes of ventricular tachycardia rapidly degenerating to ventricular fibrillation in hospital. The patient was converted with a total of 120 defibrillations. Recurrent ventricular tachycardia/fibrillation was initiated by premature ventricular beats. The patient did not respond to the use of amiodaronum. However, the administration of esmolol stabilized the patient's heart rhythm. A moderate dose of the β-blocker esmolol, administered as an 0.5-mg intravenous bolus injection followed by an infusion at a rate of 0.15 mg/kg/min, inhibited the recurrence of ventricular fibrillation and normalized the electrocardiographic pattern. The results suggest that esmolol may be able to improve the survival rate of patients with electrical storm in dilated cardiomyopathy and should be considered as a primary therapy in the management of cardiac electrical storms.
Collapse
Affiliation(s)
- L I Li
- Department of Cardiology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, P.R. China
| | - Yuan-Li Zhou
- Department of Health, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, P.R. China
| | - Xue-Jing Zhang
- Department of Cardiology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, P.R. China
| | - Hua-Ting Wang
- Department of Cardiology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, P.R. China
| |
Collapse
|
10
|
Nedios S, Darma A, Stevanello C, Richter S, Doering M, Rolf S, Sommer P, Hindricks G, Bollmann A, Arya A. Electrical storm in patients with implantable cardioverter-defibrillator in the era of catheter ablation: Implications for better rhythm control. Heart Rhythm 2015; 12:2419-25. [DOI: 10.1016/j.hrthm.2015.07.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Indexed: 11/16/2022]
|
11
|
Usefulness of scintigraphy to predict electrical storms in severe idiopathic dilated cardiomyopathy. Ann Nucl Med 2013; 27:407-15. [DOI: 10.1007/s12149-013-0699-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 02/04/2013] [Indexed: 10/27/2022]
|
12
|
Kurita T, Noda T, Nitta T, Furushima H, Shimizu A, Ohe T, Aizawa Y, Chiba Y. Nippon Storm Study design. J Arrhythm 2012. [DOI: 10.1016/j.joa.2012.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
13
|
Furushima H, Chinushi M, Iijima K, Hasegawa K, Sato A, Izumi D, Watanabe H, Aizawa Y. Is the coexistence of sustained ST-segment elevation and abnormal Q waves a risk factor for electrical storm in implanted cardioverter defibrillator patients with structural heart diseases? Europace 2011; 14:675-81. [PMID: 22158850 DOI: 10.1093/europace/eur386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
AIM The aim of this study was to determine whether or not the coexistence of sustained ST-segment elevation and abnormal Q waves (STe-Q) could be a risk factor for electrical storm (ES) in implanted cardioverter defibrillator (ICD) patients with structural heart diseases. METHODS AND RESULTS In all, 156 consecutive patients received ICD therapy for secondary prevention of sudden cardiac death and/or sustained ventricular tachyarrhythmias were included. Electrical storm was defined as ≥3 separate episodes of ventricular tachycardia (VT) and/or ventricular fibrillation (VF) terminated by ICD therapies within 24 h. During a mean follow-up of 1825 ± 1188 days, 42 (26.9%) patients experienced ES, of whom 12 had coronary artery disease, 15 had idiopathic dilated cardiomyopathy, 6 had hypertrophic cardiomyopathy, 4 had arrhythmogenic right ventricular cardiomyopathy, 4 had cardiac sarcoidosis, and 1 had valvular heart disease. Sustained ST-segment elevation and abnormal Q waves in ≥2 leads on the 12-lead electrocardiography was observed in 33 (21%) patients. On the Kaplan-Meier analysis, patients with STe-Q had a markedly higher risk of ES than those without STe-Q (P< 0.0001). The multivariate Cox proportional hazards regression model indicated that STe-Q and left ventricular ejection fraction (LVEF) (<30%) were independent risk factors associated with the recurrence of VT/VF (STe-Q: HR 1.962, 95% CI 1.24-3.12, P= 0.004; LVEF: HR 1.860, 95% CI 1.20-2.89, P= 0.006), and STe-Q was an independent risk factor associated with ES (HR 4.955, 95% CI 2.69-9.13, P< 0.0001). CONCLUSION Sustained ST-segment elevation and abnormal Q waves could be a risk factor of not only recurrent VT/VF but also ES in patients with structural heart diseases.
Collapse
Affiliation(s)
- Hiroshi Furushima
- The First Department of Internal Medicine, Niigata University School of Medicine, 1-754 Asahi-machi-dori, Niigata 951-8510, Japan
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Sekiguchi Y, Tada H, Yoshida K, Seo Y, Li S, Tejima T, Shoda M, Kamakura S, Aonuma K. Significant increase in the incidence of ventricular arrhythmic events after an intrathoracic impedance change measured with a cardiac resynchronization therapy defibrillator. Circ J 2011; 75:2614-20. [PMID: 21891969 DOI: 10.1253/circj.cj-11-0327] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cardiac resynchronization therapy defibrillator (CRT-D) devices are now capable of monitoring changes in intrathoracic impedance. Intrathoracic impedance monitoring resulting in a fluid index threshold crossing has been proven to predict heart failure (HF) exacerbations. We retrospectively investigated the relationship between changes in intrathoracic impedance and the occurrence of arrhythmic events. METHODS AND RESULTS From 282 patients with New York Heart Association class III or IV HF who were implanted with a CRT-D device with a fluid index feature based on intrathoracic impedance monitoring capabilities, arrhythmic events were retrospectively analyzed in terms of the threshold crossings. The patients were divided into 2 groups: those with fluid index threshold crossings and those without threshold crossings. A total of 4,725 tachyarrhythmic events were reported in 129 patients (46%), and there were 221 fluid index crossing events in 145 patients (51%) during 10.0 ± 3.2 months. Tachyarrhythmic events were more frequently recorded in patients with threshold crossing events than in those who did not experience a threshold crossing (3,241 vs. 1,484 events, P<0.0001). Ventricular tachyarrhythmic events mainly occurred within the first 30 days after the threshold crossing event; however, a similar trend was not observed for the atrial tachyarrhythmic events. CONCLUSIONS Intrathoracic impedance monitoring may predict arrhythmic events, especially ventricular arrhythmias, in patients with HF and provides an additional management tool.
Collapse
Affiliation(s)
- Yukio Sekiguchi
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Tsai WC, Chang SL, Hsieh JC, Chen YC, Wang JH, Chen SA. Late diastolic potential guided ventricular tachycardia ablation in patient with electrical storms and ischemic heart disease. Circ J 2011; 75:1255-7. [PMID: 21343654 DOI: 10.1253/circj.cj-10-0968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Wen-Chin Tsai
- Division of Cardiology, Department of Medicine, Hualein Tzu-Chi General Hospital, Taipei, Taiwan
| | | | | | | | | | | |
Collapse
|