Predictors and proarrhythmic consequences of inappropriate implantable cardioverter-defibrillator therapy

Taro Tenma, Hisashi Yokoshiki, Kazuya Mizukami, Hirofumi Mitsuyama, Masaya Watanabe, Ryo Sasaki, Motoki Maeno, Yoshiro Matsui, Hiroyuki Tsutsui

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Despite the benefits of implantable cardioverter-defibrillator (ICD) therapy, inappropriate shocks can lead to multiple adverse effects. The aim of this study was to clarify the predictors of inappropriate ICD shocks and their proarrhythmic consequences. Methods and Results: We retrospectively studied 316 consecutive patients who underwent ICD implantation from December 2000 to December 2011. Of them, 70 (22%) experienced inappropriate ICD shocks without proarrhythmia requiring some intervention; 2 patients (0.6%) had proarrhythmic inappropriate ICD therapy by antitachycardia pacing (ATP), thereby calculated to be 0.18% of patients per year. However, they did not have syncope from this inappropriate ATP. Multivariate analysis identified younger age (≤56 years: hazard ratio [HR] 1.68, 95% confidence interval [CI] 1.02-2.77, P=0.043), paroxysmal atrial fibrillation (HR 3.00, 95% CI 1.64-5.31, P=0.0002), stroke (HR 2.23, 95% CI 1.11-4.47, P=0.024), and no diuretic use (HR 1.72, 95% CI 1.03-2.93, P=0.039) as independent predictors of the occurrence of inappropriate ICD shocks. Conclusions: Young age, paroxysmal atrial fibrillation, stroke, and no use of diuretics were independently associated with inappropriate ICD shocks. Proarrhythmic inappropriate ICD therapy was observed with an annual incidence of 0.18% by ATP.

Original languageEnglish
Pages (from-to)1920-1927
Number of pages8
JournalCirculation Journal
Volume79
Issue number9
DOIs
Publication statusPublished - Aug 25 2015
Externally publishedYes

    Fingerprint

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this