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Ventricular fibrillation (VF) is characterized by rapid (>300 beats a per minute), irregular electrical activation with variable electrocardiographic waveforms that prevents coordinated myocardial contraction, resulting in immediate loss of cardiac output.1 It most commonly occurs in the context of coronary artery disease.2,3 Resuscitation efforts are critically time-dependent: with each minute of untreated VF, the survival rate declines […]

Predictors of appropriate therapy in patients with implantable cardioverter-defibrillator for primary prevention of sudden cardiac death

Imdad Ahmed, William B. Nelson, Chad M. House, Dennis W.X. Zhu
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Published Online: Jul 31st 2018 Heart International 2010;5(1):e4 DOI: https://doi.org/10.4081/hi.2010.e4
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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.

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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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