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Related Experiment Videos

Is inappropriate implantable defibrillator shock therapy predictable?

Kumaraswamy Nanthakumar1, Paul Dorian, Miney Paquette

  • 1Arrhythmia Service, Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|June 20, 2003
PubMed
Summary

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Identifying patients at risk for inappropriate implantable cardioverter defibrillator (ICD) shock is crucial. Prior atrial fibrillation (AF) and NYHA class predict inappropriate ICD shocks, guiding interventions to improve patient safety.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Clinical Electrophysiology

Background:

  • Inappropriate shocks from implantable cardioverter defibrillators (ICDs) are common, often triggered by atrial fibrillation (AF) or sinus tachycardia (ST).
  • Predicting which patients are at higher risk for inappropriate shocks is essential for optimizing device therapy.
  • This study investigated clinical variables to identify patients with single-chamber ICDs susceptible to inappropriate shocks.

Purpose of the Study:

  • To identify implantable cardioverter defibrillator (ICD) patients at risk of receiving inappropriate shocks.
  • To determine if clinical variables can predict inappropriate ICD therapy.
  • To evaluate the utility of clinical predictors for patients receiving single-chamber ICDs.

Main Methods:

Related Experiment Videos

  • Retrospective analysis of data from an ICD registry.
  • Inappropriate shock was the primary outcome variable.
  • Stepwise logistic regression identified predictors including age, gender, ejection fraction, NYHA class, prior CABG, and prior AF history.

    • Main Results:

    • Of 261 analyzed patients, 44% received inappropriate shocks, with 73% occurring within 2 years.
    • Prior atrial fibrillation (AF) (OR 2.6) and NYHA class (class 1 vs. 2-4, OR 2.2) were significant multivariate predictors of inappropriate therapy.
    • Male gender (78%), mean age 60 years, and mean ejection fraction 37% characterized the study population.

    Conclusions:

    • Clinical characteristics of ICD patients can predict those at risk for inappropriate shock.
    • Identifying high-risk patients allows for targeted interventions to reduce inappropriate shocks.
    • Consideration of prior AF and NYHA class is important for managing ICD patients.