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Titolo:
POTENTIAL BENEFIT FROM IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR THERAPYIN PATIENTS WITH AND WITHOUT HEART-FAILURE
Autore:
BOCKER D; BANSCH D; HEINECKE A; WEBER M; BRUNN J; HAMMEL D; BORGGREFE M; BREITHARDT G; BLOCK P;
Indirizzi:
UNIKLIN MUNSTER D-48129 MUNSTER GERMANY UNIV MUNSTER,HOSP WESTFAL WILHELMS,DEPT CARDIOL D-4400 MUNSTER GERMANY UNIV MUNSTER,HOSP WESTFAL WILHELMS,DEPT CARDIOTHORAC SURG D-4400 MUNSTER GERMANY UNIV MUNSTER,HOSP WESTFAL WILHELMS,DEPT MED INFORMAT D-4400 MUNSTER GERMANY UNIV MUNSTER,HOSP WESTFAL WILHELMS,INST ARTERIOSCLEROSIS RES D-4400 MUNSTER GERMANY
Titolo Testata:
Circulation
fascicolo: 16, volume: 98, anno: 1998,
pagine: 1636 - 1643
SICI:
0009-7322(1998)98:16<1636:PBFICT>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR FUNCTION; HIGH-RISK; AUTOMATIC DEFIBRILLATORS; MORTALITY; TACHYARRHYTHMIAS; ARRHYTHMIAS; SURVIVAL; DISEASE;
Keywords:
HEART FAILURE; PROGNOSIS; CARDIOVERSION; DEFIBRILLATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
17
Recensione:
Indirizzi per estratti:
Citazione:
D. Bocker et al., "POTENTIAL BENEFIT FROM IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR THERAPYIN PATIENTS WITH AND WITHOUT HEART-FAILURE", Circulation, 98(16), 1998, pp. 1636-1643

Abstract

Background-Whether patients with heart failure derive a benefit from therapy with implantable cardioverter-defibrillators (ICDs) has been questioned. The purpose of this study was to investigate whether New York Heart Association (NYHA) functional class had an impact on the potential benefit from ICD therapy as assessed from data stored in the memory of ICDs. Methods and Results-Between 1989 and 1996, 603 patients (77% men; 59% with coronary artery disease and 16% with dilated cardiomyopathy; age, 57+/-13 years; ejection fraction, 44+/-18%) were treatedwith an ICD with extended memory function (storage of electrograms and/or RR intervals from treated episodes) in combination with endocardial lead systems. The stages of heart failure (NYHA functional class I through III) at implantation were correlated with overall mortality and the recurrence of fast ventricular tachyarrhythmias (>240 bpm) during follow-up. The potential benefit of the device was estimated as the difference between overall mortality and the hypothetical death rate had the device not been implanted. The latter was based on the recurrence of fast and, without termination by the devices, presumably fatal ventricular tachyarrhythmias. In the overall group, a significant difference between hypothetical death rate and overall mortality was observed (13.9%, 23.5%, and 26.6% at 1, 3, and 5 years, respectively) that suggested a benefit from ICD implantation. In patients in NYHA class I,the estimated benefit, which increased over time, was 15.2%, 29.2%, and 35.6% after 1, 3, and 5 years, respectively. Tn patients in NYHA class II or III, the estimated benefit increased until the third year (21.8% and 21.9%, respectively) and then remained constant until the fifth year (22.9% and 23.8%, respectively). Even those patients in NYHA class III with a history of decompensated heart failure benefited from ICD implantation. Conclusions-Analysis of stored ECG data suggests that in patients with a history of ventricular tachycardia or ventricularfibrillation, ICD therapy may lead to a prolongation of life in NYHA classes I through III. The initial benefit is greatest in patients in NYHA class II and class III, but the estimated benefit might persist longest for patients in NYHA class I.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 13/07/20 alle ore 12:13:42