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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Physical functioning and mental well-being in association with health outcome in patients enrolled in the Multicenter
Katarzyna Piotrowicz1, Katia Noyes, Jeffrey M Lyness
1Heart Research Follow-up Program, Cardiology Division, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Ave, PO Box 653, Rochester, NY 14642, USA.
European Heart Journal
|February 14, 2007
Summary
Lower physical and mental health scores in congestive heart failure (CHF) patients predict worse outcomes, including death and hospitalization. These factors, however, do not predict implantable cardioverter-defibrillator (ICD) therapy effectiveness.
Area of Science:
- Cardiology
- Psychosomatic Medicine
Background:
- The interplay between psychosocial factors, physical health, and outcomes in congestive heart failure (CHF) patients requires further investigation.
- Advanced left ventricular dysfunction in post-infarction patients presents unique challenges for managing health outcomes.
Purpose of the Study:
- To evaluate the relationship between physical and mental health status and health outcomes in post-infarction patients with advanced left ventricular dysfunction.
- To determine if physical and mental health component summaries predict mortality, CHF hospitalization, and implantable cardioverter-defibrillator (ICD) therapy.
Main Methods:
- Utilized data from 1058 patients in the Multicenter Automatic Defibrillator Implantation Trial II (MADIT II).
- Assessed physical component summary (PCS) and mental component summary (MCS) using the Medical Outcome Trust Short Form (SF-12) at baseline.
- Analyzed the association of PCS and MCS with survival, CHF hospitalization, and ICD therapy, adjusting for clinical covariates.
Main Results:
- Both baseline PCS and MCS were significantly associated with increased risk of death and CHF hospitalization (P < 0.001 and P < 0.016 for PCS; P
- Low PCS and MCS remained significant predictors of mortality and CHF hospitalization even after adjusting for covariates.
- Neither PCS nor MCS predicted appropriate ICD therapy for ventricular tachyarrhythmias; however, patients receiving ICD shocks showed a significant PCS decline but not MCS decline over 12 months.
Conclusions:
- Reduced physical and mental health component summaries at baseline are linked to poorer health outcomes, including mortality and hospitalization, in MADIT II patients.
- PCS and MCS do not appear to be associated with the efficacy of appropriate ICD therapy for ventricular tachyarrhythmias.
- Experiencing ICD shocks correlates with a decline in physical health but not mental health over time.
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