Predictors and Proarrhythmic Consequences of Inappropriate Implantable Cardioverter-Defibrillator Therapy

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

Title	en Predictors and Proarrhythmic Consequences of Inappropriate Implantable Cardioverter-Defibrillator Therapy
Creator	en Tenma, Taro en Yokoshiki, Hisashi NRID 1000040360911 en Mizukami, Kazuya en Mitsuyama, Hirofumi en Watanabe, Masaya en Sasaki, Ryo en Maeno, Motoki en Matsui, Yoshiro NRID 1000090219379 en Tsutsui, Hiroyuki NRID 1000070264017
Accessrights	open access
Subject	Other en Antitachycardia pacing Other en Implantable cardioverter-defibrillator Other en Inappropriate shock Other en Paroxysmal atrial fibrillation Other en Proarrhythmia NDC 490
Description	Abstract en 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.
Publisher	en The Japanese Circulation Society
Date	Issued2015-08-25
Language	eng
Resource Type	journal article
Version Type	VoR
Identifier	HDL http://hdl.handle.net/2115/71892
Relation	isIdenticalTo DOI https://doi.org/10.1253/circj.CJ-15-0306 PMID 26104029
Journal	PISSN 1346-9843 EISSN 1347-4820 en Circulation Journal Volume Number79 Issue Number9 Page Start1920 Page End1927
File	fulltext 79_CJ-15-0306.pdf 1.3 MB (application/pdf) Issued2015-08-25 fulltext 79_CJ-15-0306_1.pdf 382.12 KB (application/pdf) Issued2015-08-25
Oaidate	2023-07-26