Title |
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Electrical Storm as an Independent Mortality Risk in Patients with Preserved or Moderately Reduced Left Ventricular Function Results from a Japanese Nationwide Registry
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Creator |
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Accessrights |
metadata only access |
Subject |
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Other
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Ventricular tachycardia
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Other
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Non-ischemic heart disease
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Other
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Mortality
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Other
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Implantable cardioverter-defibrillator
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NDC
490
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Description |
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Abstract
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Electrical storm (ES), defined by 3 or more occurrences of ventricular arrhythmias within 24 hours, has been shown to be associated with an increased risk of mortality; however, detailed information remains lacking. We aimed to examine the incidence and determinants of ES and its impact on mortality in patients enrolled in the nationwide implantable cardioverter-defibrillator (ICD) registry. We studied 1,256 patients (age 65 +/- 12 years) who had structural heart disease with an ICD. The patients were classified into reduced ejection fraction (EF < 35%; 657 (52%) patients) and preserved or moderately reduced EF (EF >= 35%; 599 (48%) patients). ES occurred in 49 (7%) and 36 (6%) patients in the EF < 35% and EF >= 35% groups (log-rank P = 0.297) during the median follow-up of 2.3 years. ICD with resynchronization therapy was associated with a lower incidence of ES in patients with EF < 35%. Non-ischemic heart disease and diuretics were associated with ES in patients with EF >= 35%. During the follow-up, 10/49 (20%) patients with ES and 80/608 patients (13%) without ES died in patients with EF < 35%, while 7/36 (19%) patients with ES and 38/563 patients (7%) without ES died in those with EF >= 35%. We have created 4 Cox multivariate models. All models showed approximately 2-fold higher hazard ratios in patients with EF >= 35% compared to EF < 35%. Our study showed that the determinants of ES differed between EF < 35% and EF >= 35%. The impact of ES for mortality was numerically higher in EF >= 35% than in EF < 35%, although a significant interaction was not detected.
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Publisher |
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International Heart Journal Association
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Date |
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Language |
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Resource Type |
journal article |
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NA |
Identifier |
HDL
http://hdl.handle.net/2115/84302
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Relation |
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DOI
https://doi.org/10.1536/ihj.20-832
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Journal |
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International heart journal
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Volume Number62
Issue Number6
Page Start1249
Page End1256
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Oaidate |
2023-07-26 |