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Titolo:
INAPPROPRIATE ICD-THERAPIES - INCIDENCE, CAUSES, RISK-FACTORS AND PREVENTION
Autore:
WEBER M; BLOCK M; BRUNN J; BANSCH D; BOCKER D; HAMMEL D; GIETZEN F; BREITHARDT G;
Indirizzi:
UNIV MUNSTER,MED KLIN & POLIKLIN,ALBERT SCHWEITZER STR 33 D-48129 MUNSTER GERMANY UNIV MUNSTER,KLIN & POLIKLIN THORAX HERZ & GEFASSCHIRURG D-48129 MUNSTER GERMANY STADT KRANKENANSTALTEN BIELEFELD MITTE,MED KLIN 2 D-33604 BIELEFELD GERMANY
Titolo Testata:
Zeitschrift fur Kardiologie
fascicolo: 11, volume: 85, anno: 1996,
pagine: 809 - 819
SICI:
0300-5860(1996)85:11<809:II-ICR>2.0.ZU;2-G
Fonte:
ISI
Lingua:
GER
Soggetto:
IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR; VENTRICULAR-TACHYCARDIA; CLINICAL-EXPERIENCE; ATRIAL-FIBRILLATION; CYCLE LENGTH; FOLLOW-UP; COMPLICATIONS; SHOCKS; TACHYARRHYTHMIAS; ARRHYTHMIAS;
Keywords:
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR; INAPPROPRIATE ICD-THERAPIES; UNNECESSARY SHOCKS; STORED ELECTROGRAMS;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
43
Recensione:
Indirizzi per estratti:
Citazione:
M. Weber et al., "INAPPROPRIATE ICD-THERAPIES - INCIDENCE, CAUSES, RISK-FACTORS AND PREVENTION", Zeitschrift fur Kardiologie, 85(11), 1996, pp. 809-819

Abstract

Patients with implantable cardioverter defibrillators (ICD) often suffer inappropriate ICD-therapies. The incidence, causes and risk factors of ICD-therapies for a rhythm other than ventricular tachyarrhythmias (VT) were determined retrospectively in 462 consecutive patients (pts). Inappropriate ICD-therapies were identified based on stored R-R intervals and/or electrograms. Eighty-two pts (18%) had inappropriate ICD-therapies. Actuarial rates for inappropriate ICD-therapies were 13%,20%, 24% and 29% at 1, 2, 3 and 4 years after ICD-implantation, respectively. Atrial fibrillation with rapid ventricular response was the most common cause (34 pts, 39%). In 26 pts (30%), sinus tachycardia triggered inappropriate ICD-therapies, in 21 pts (24%) oversensing, mostly due to fractures and insulation failures of the leads, in three pts atrial flutter, in two pts non-sustained VT, in one pt supraventricular tachycardia and in another pt T-wave double sensing caused inappropriate ICD-therapies. In order to prevent recurrences of inappropriate ICD-therapies due to atrial fibrillation or sinus tachycardia, a rate stability (n = 19) or onset (n = 15) criterion was programmed, 41 pts additionally received betablocking agents and/or digoxin. In pts with oversensing an operative revision of lead system was performed. During further follow-up (15 +/- 13 months), 15 pts had recurrences of inappropriate ICD-therapies (eight pts due to atrial fibrillation, three dueto sinus tachycardia and four due to oversensing). On multivariate analysis (Cox regression), history of atrial fibrillation, maximum heartrate during exercise and low cut-off rate for VT-detection were predictors of inappropriate ICD-therapies. Thus, inappropriate ICD-therapies are frequent, especially in the first year after implantation. Additional detection criteria, betablocking agents and/or digoxin prevent recurrences in most patients. In patients with a history of atrial fibrillation, high heart rate during exercise or a low cut-off rate for VT-detection, activation of additional detection criteria should be considered directly after ICD-implantation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/09/20 alle ore 23:44:25