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Prognostic value of noninvasive programmed stimulation in primary prevention implantable cardioverter-defibrillator recipients.
Futyma, Piotr; Santangeli, Pasquale; Zarebski, Lukasz; Wrzos, Aleksandra; Sander, Jaroslaw; Futyma, Marian; Marchlinski, Francis E; Kulakowski, Piotr.
Afiliación
  • Futyma P; St. Joseph's Heart Rhythm Center Rzeszów Poland.
  • Santangeli P; Medical College University of Rzeszów Rzeszów Poland.
  • Zarebski L; Section of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute Cleveland Clinic Foundation Cleveland Ohio USA.
  • Wrzos A; St. Joseph's Heart Rhythm Center Rzeszów Poland.
  • Sander J; Medical College University of Rzeszów Rzeszów Poland.
  • Futyma M; Medical College University of Rzeszów Rzeszów Poland.
  • Marchlinski FE; St. Joseph's Heart Rhythm Center Rzeszów Poland.
  • Kulakowski P; St. Joseph's Heart Rhythm Center Rzeszów Poland.
J Arrhythm ; 40(3): 578-584, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38939799
ABSTRACT

Background:

Implantable cardioverter-defibrillator (ICD) offers an opportunity to study inducibility of ventricular tachycardia (VT) or ventricular fibrillation (VF) by performing noninvasive programmed ventricular stimulation (NIPS). Whether NIPS can predict future arrhythmic events or mortality in patients with primary prevention ICD, has not yet been examined.

Methods:

From the NIPS-ICD study (ClinicalTrials ID NCT02373306) 41 consecutive patients (34 males, age 64 ± 11 years, 76% ischemic cardiomyopathy [ICM]) had ICD for primary prevention indication. Patients underwent NIPS using a standardized protocol of up to three premature extrastimuli at 600, 500 and 400 ms drive cycle lengths. NIPS was classified as positive if sustained VT or VF was induced. The study endpoint was occurrence of sustained VT/VF during the follow-up.

Results:

At baseline NIPS, VT/VF was induced in 8 (20%) ICM patients. During the 5-year follow-up, the VT/VF occurred in 7 (17%) patients, all with ICM. The difference between NIPS-inducible versus NIPS-noninducible patients regarding VT/VF occurrence did not meet statistical significance (38% vs. 12%, log rank test p = .11). After a 5-year follow-up, the mortality rate was significantly higher in patients who had VT/VF induced at NIPS versus no VT/VF at NIPS (38% vs. 12%, p = .043). The occurrence of a composite endpoint consisting of VT/VF recurrence or death in patients with ICM was also most frequent in the NIPS-inducible group (75% vs. 35%, p = .037).

Conclusions:

Inducibility of VT/VF during NIPS in ICM patients with primary prevention ICD is associated with higher mortality and higher incidence of composite endpoint consisting of death or VT/VF during a long-term observation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Arrhythm Año: 2024 Tipo del documento: Article Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Arrhythm Año: 2024 Tipo del documento: Article Pais de publicación: Japón