Digitalis Therapy Is Associated With an Increased Risk of ICD Shock Delivery and Device Revision

Area of Science:

• Cardiology
• Electrophysiology
• Heart Failure Management

Background:

• Digitalis glycosides are used for atrial fibrillation rate control and heart failure treatment.
• Previous research has indicated potential adverse effects of digitalis therapy.
• The study investigated digitalis use in patients with systolic heart failure undergoing ICD or CRT-ICD implantation.

Purpose of the Study:

• To determine the prevalence of digitalis therapy in patients receiving cardiac implantable electronic devices.
• To assess the impact of digitalis therapy on clinical outcomes in this patient population.

Main Methods:

• Analysis of data from the German Device Registry, a nationwide prospective registry.
• Inclusion of 3826 patients undergoing ICD or CRT system implantation.
• Comparison of outcomes between patients receiving digitalis therapy and those who were not.

Main Results:

• Digitalis-treated patients had more severe left ventricular dysfunction, higher NYHA class, and more left bundle branch block.
• One-year mortality and a composite endpoint of death, myocardial infarction, or stroke did not differ significantly between groups.
• Digitalis therapy was associated with increased ICD shock delivery and a higher risk of device revision.

Conclusions:

• Digitalis therapy in patients with systolic heart failure undergoing ICD or CRT implantation is associated with an increased risk of device revision.
• No significant difference in mortality or major adverse cardiovascular events was observed.
• An elevated risk of ICD shock delivery was noted in patients treated with digitalis.