Efficacy and safety of implantable cardiac defibrillators for treatment of ventricular arrhythmias in patients with cardiac sarcoidosis

被引：120

作者：

Kron, Jordana ^{[1
]}

Sauer, William ^{[2
]}

Schuller, Joseph ^{[2
]}

Bogun, Frank ^{[3
]}

Crawford, Thomas ^{[3
]}

Sarsam, Sinan ^{[3
]}

Rosenfeld, Lynda ^{[4
]}

Mitiku, Teferi Y. ^{[4
]}

Cooper, Joshua M. ^{[5
]}

Mehta, Davendra ^{[6
]}

Greenspon, Arnold J. ^{[7
]}

Ortman, Matthew ^{[7
]}

Delurgio, David B. ^{[8
]}

Valadri, Ravinder ^{[8
]}

Narasimhan, Calambur ^{[9
]}

Swapna, Nalla ^{[9
]}

Singh, Jagmeet P. ^{[10
]}

Danik, Stephan ^{[10
]}

Markowitz, Steven M. ^{[11
]}

Almquist, Adrian K. ^{[12
]}

Krahn, Andrew D. ^{[13
]}

Wolfe, Luke G. ^{[14
]}

Feinstein, Shawn ^{[1
]}

Ellenbogen, Kenneth A. ^{[1
]}

机构：

[1] Virginia Commonwealth Univ, Dept Cardiac Electrophysiol, Richmond, VA 23298 USA

[2] Univ Colorado, Dept Cardiol, Denver, CO 80202 USA

[3] Univ Michigan, Dept Cardiol, Ann Arbor, MI 48109 USA

[4] Yale Univ, Dept Cardiac Electrophysiol, New Haven, CT USA

[5] Univ Penn, Dept Cardiol, Philadelphia, PA 19104 USA

[6] Mt Sinai Hosp, Dept Cardiol, New York, NY 10029 USA

[7] Thomas Jefferson Univ Hosp, Div Cardiol, Philadelphia, PA 19107 USA

[8] Emory Univ, Dept Cardiol, Atlanta, GA 30322 USA

[9] CARE Hosp, Dept Cardiol, Hyderabad, Andhra Pradesh, India

[10] Massachusetts Gen Hosp, Dept Cardiol, Boston, MA 02114 USA

[11] Weill Cornell Med Ctr, Dept Cardiol, New York, NY USA

[12] Minneapolis Heart Inst, Dept Cardiol, Minneapolis, MN USA

[13] Univ Western Ontario, Div Cardiol, London, ON, Canada

[14] Virginia Commonwealth Univ, Dept Gen Surg, Richmond, VA 23298 USA

来源：

EUROPACE | 2013年 / 15卷 / 03期

关键词：

Implantable cardiac defibrillator; Cardiac sarcoidosis; LEAD FAILURE; STIMULATION; THERAPY;

D O I：

10.1093/europace/eus316

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims Implantable cardiac defibrillator (ICD) implantation is a class IIA recommendation for patients with cardiac sarcoidosis (CS). However, little is known about the efficacy and safety of ICDs in this population. The goal of this multi-centre retrospective data review was to evaluate the efficacy and safety of ICDs in patients with CS. Methods and results Electrophysiologists at academic medical centres were asked to identify consecutive patients with CS and an ICD. Clinical information, ICD therapy history, and device complications were collected for each patient. Data were collected on 235 patients from 13 institutions, 64.7% male with mean age 55.6 +/- 11.1. Over a mean follow-up of 4.2 +/- 4.0 years, 85 of 234 (36.2%) patients received an appropriate ICD therapy (shocks and/or anti-tachycardia pacing) and 67 of 226 (29.7%) received an appropriate shock. Fifty-seven of 235 patients (24.3%) received a total of 222 inappropriate shocks. Forty-six adverse events occurred in 41 of 235 patients (17.4%). Patients who received appropriate ICD therapies were more likely to be male (73.8 vs. 59.6%, P = 0.0330), have a history of syncope (40.5 vs. 22.5%, P = 0.0044), lower left ventricular ejection fraction (38.1 +/- 15.2 vs. 48.8 +/- 14.7%, P <= 0.0001), ventricular pacing on baseline electrocardiogram (16.1 vs. 2.1%, P = 0.0002), and a secondary prevention indication (60.7 vs. 24.5%, P < 0.0001) compared with those who did not receive appropriate ICD therapies. Conclusion Patients with CS and ICDs are at high risk for ventricular arrhythmias. This population also has high rates of inappropriate shocks and device complications.

引用

页码：347 / 354

页数：8

共 18 条

[1] Usefulness of programmed ventricular stimulation in predicting future arrhythmic events in patients with cardiac sarcoidosis [J].