Predictors of appropriate therapy in patients with implantable cardioverter-defibrillator for primary prevention of sudden cardiac death
Abstract
Overview
The purpose of this study was to evaluate
predictors of appropriate therapy in patients
with implantable cardioverter-defibrillators
(ICD) for primary prevention of sudden cardiac
death. A retrospective cohort of 321
patients with systolic heart failure undergoing
ICD placement for primary prevention of sudden
cardiac death was queried with a mean
follow-up period of 2.6 years. Appropriate ICD
therapy was defined as therapy delivered for
termination of a ventricular tachyarrhythmia.
Appropriate ICD therapy was delivered in 142
(44%) of the patients. In a multivariate model,
body mass index ≥28.8 kg/m2 , chronic kidney
disease, left ventricular ejection fraction ≤20%
and metabolic syndrome were found to be
independent predictors of appropriate ICD
therapy. Appropriate ICD therapy was associated
with higher cardiovascular mortality. These
findings show the importance of identification
of risk factors, especially metabolic syndrome,
in patients following ICD implantation as
aggressive treatment of these co-morbidities
may decrease appropriate ICD therapy and
cardiovascular mortality.
Keywords
Metabolic syndrome, ICD therapy, chronic kidney disease, systolic heart failure.
Article Information
Correspondence
Dennis W.X. Zhu, Cardiology 11102H, Regions Hospital, 640 Jackson Street, Saint Paul, MN 55101, USA. E-mail: dennis.w.zhu@healthpartners.com
Received
2010-02-03
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