Long-term follow-up of implantable cardioverter defibrillator patients with regard to appropriate therapy, complications, and mortality

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Mattsson, GustavUppsala universitet,Centrum för klinisk forskning, Gävleborg (författare)

Long-term follow-up of implantable cardioverter defibrillator patients with regard to appropriate therapy, complications, and mortality

Artikel/kapitelEngelska2020

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2020-01-22
Wiley,2020
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:uu-425652
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-425652URI
https://doi.org/10.1111/pace.13869DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:142790930URI

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Språk:engelska
Sammanfattning på:engelska

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BackgroundAn implantable cardioverter defibrillator (ICD) is recommended for patients with symptomatic heart failure with ejection fraction ≤35% despite optimal medical therapy. More recently, the benefits of ICDs have been questioned in nonischemic cardiomyopathy (CM).AimTo examine the incidence of appropriate therapy, complications, mortality, and cause of death among ICD patients in an unselected validated cohort. In primary prevention, appropriate therapy in ischemic versus nonischemic CM will be evaluated.MethodsA retrospective observational study of patients in Region Gävleborg, Sweden, who underwent ICD implantation or replacement between 2007 and 2017.ResultsIn total, 438 patients (mean age at implant: 65.9 ± 11.2 years, 82.0% males, mean follow‐up: 5.2 ± 4.0 years) were included. There were 108 (24.7%) deaths (49.1% due to heart failure) and 94.9% survived the first year. Cumulative incidence of appropriate therapy at 5‐year was 31.6%. Cumulative incidence of inappropriate shock at 5‐year was 9.1%. A total of 98 complications requiring surgical intervention occurred (annual rate: 4.3%). In total, 236 patients with primary prevention due to ischemic (61.9%) or nonischemic (38.1%) CM were included. During a mean follow‐up of 3.9 ± 2.5 years, for appropriate therapy, there was no significant difference (P = .985) between ischemic (cumulative incidence at 1, 3, and 5 years: 6.4%, 17.1%, and 19.6%) and nonischemic CM (cumulative incidence at 1, 3, and 5 years: 5.6%, 13.6%, and 24.4%).ConclusionIschemic and nonischemic CM confer similar risk of ventricular arrhythmia. This supports current guidelines regarding primary‐prevention ICD. Short‐term survival is excellent but complications remain a problem.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
arrhythmia
cardiomyopathy
heart failure
implantable cardioverter-defibrillator
risk stratification
sudden death

Biuppslag (personer, institutioner, konferenser, titlar ...)

Magnusson, PeterKarolinska Institutet,Uppsala universitet,Centrum för klinisk forskning, Gävleborg,Karolinska Inst, Dept Med, Cardiol Res Unit, SE-17176 Stockholm, Sweden (författare)
Uppsala universitetCentrum för klinisk forskning, Gävleborg (creator_code:org_t)

Sammanhörande titlar

Ingår i:Pacing and Clinical Electrophysiology: Wiley43:2, s. 245-2530147-83891540-8159

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Pacing and Clinical Electrophysiology (Sök värdpublikationen i LIBRIS)

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Av författaren/redakt...: Mattsson, Gustav; Magnusson, Peter

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

Artiklar i publikationen: Pacing and Clini ...

Av lärosätet: Uppsala universitet; Karolinska Institutet

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