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Titolo:
SYNCOPE IN PATIENTS WITH AN IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR - INCIDENCE, PREDICTION AND IMPLICATIONS FOR DRIVING RESTRICTIONS
Autore:
BANSCH D; BRUNN J; CASTRUCCI M; WEBER M; GIETZEN F; BORGGREFE M; BREITHARDT G; BLOCK M;
Indirizzi:
UNIV MUNSTER,DEPT CARDIOL & ANGIOL D-48129 MUNSTER GERMANY UNIV MUNSTER,INST ARTERIOSCLEROSIS RES D-4400 MUNSTER GERMANY STADT KRANKENANSTALTEN BIELEFELD MITTE,DEPT INTERNAL MED 2 BIELEFELD GERMANY
Titolo Testata:
Journal of the American College of Cardiology
fascicolo: 3, volume: 31, anno: 1998,
pagine: 608 - 615
SICI:
0735-1097(1998)31:3<608:SIPWAI>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
VENTRICULAR-TACHYCARDIA; ARRHYTHMIAS; THERAPY; SHOCKS; RECOMMENDATIONS; CONSCIOUSNESS; FIBRILLATION; AMIODARONE; SURVIVORS; CRITERIA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
31
Recensione:
Indirizzi per estratti:
Citazione:
D. Bansch et al., "SYNCOPE IN PATIENTS WITH AN IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR - INCIDENCE, PREDICTION AND IMPLICATIONS FOR DRIVING RESTRICTIONS", Journal of the American College of Cardiology, 31(3), 1998, pp. 608-615

Abstract

Objectives. This retrospective study was undertaken to provide information on occurrence, risk predict-ion and prevention of syncope in patients with an implantable cardioverter-defibrillator (ICD), Background. ICDs effectively terminate ventricular tachycardia and fibrillation (VT/VF). Incapacitating symptoms, such as syncope, may still occur, Methods. We performed a retrospective analysis of data from 421 patients(clinical history, outpatient chart reviews and episode data) with mean (+/-SD) follow-up of 26 +/- 18 months, Results, Of 421 patients, 229 (54.4%) had recurrent VT/VF, and 62 (14.7%) had syncope. The actuarial survival rate free VT/VF was 58%, 45% and 37% and that for survivalfree of syncope was 90%, 85% and 81% at 12, 24 and 36 months after implantation, respectively. Once VT/VF had occurred, 76%, 68% and 62% ofpatients remained free of syncope during the following 12, 24 and 36 months, and 68%, 64% and 56% remained free of second syncope 12, 24 and 36 months after first syncope, respectively. In cases of syncope, the mean cycle length (CL) of VT was 251 +/- 56 ms, A low baseline left ventricular ejection fraction (LVEF), induction of fast VT (CL <300 ms) during programmed ventricular stimulation and chronic atrial fibrillation (AF) were associated with an increased risk of syncope, If the LVEF was >40%, fast VT had not been induced, and patients had no chronic AF: 96%, 92% and 92% of patients remained free of syncope after 12, 24 and 36 months, respectively, Once patients had a VT recurrence, syncope during the first VT and a high VT rate were the strongest risk predictors of future syncope, Conclusions, Identification of patients with an ICU with a low and high risk of syncope seems to be feasible andmight help as a guide to driving restrictions in such patients. (C) 1998 by the American College of Cardiology.

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Documento generato il 11/07/20 alle ore 17:42:01