Effect of Significant Weight Change on Inappropriate Implantable Cardioverter-Defibrillator Therapy

被引：3

作者：

Daimee, Usama A. ^{[1
]}

Biton, Yitschak ^{[1
]}

Aktas, Mehmet K. ^{[1
]}

Zannad, Faiez ^{[2
]}

Klein, Helmut ^{[1
]}

Szepietowska, Barbara ^{[1
]}

Mcnitt, Scott ^{[1
]}

Polonsky, Bronislava ^{[1
]}

Wang, Paul J. ^{[3
]}

Zareba, Wojciech ^{[1
]}

Moss, Arthur J. ^{[1
]}

Kutyifa, Valentina ^{[1
]}

机构：

[1] Univ Rochester, Med Ctr, Div Cardiol, Heart Res Follow Up Program, 265 Crittenden Blvd,POB 653, Rochester, NY 14642 USA

[2] Univ Lorraine, Nancy Univ, Dept Cardiol, Nancy, France

[3] Stanford Univ, Sch Med, Div Cardiol, Palo Alto, CA 94304 USA

来源：

PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2017年 / 40卷 / 01期

关键词：

weight change; mild heart failure; cardiac resynchronization therapy; inappropriate implantable cardioverter-defibrillator therapy; supraventricular arrhythmias; CARDIAC-RESYNCHRONIZATION THERAPY; CHRONIC HEART-FAILURE; BODY-MASS INDEX; MORBIDITY CHARM PROGRAM; ATRIAL-FIBRILLATION; MADIT-CRT; RISK-FACTOR; MORTALITY; TRIAL; REDUCTION;

D O I：

10.1111/pace.12973

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Weight loss has been associated with adverse outcomes among heart failure (HF) patients, including those receiving cardiac resynchronization therapy with defibrillator (CRT-D). The effect of significant weight change on inappropriate implantable cardioverter-defibrillator (ICD) therapy among CRT-D patients is not well understood. Methods: We evaluated the impact of significant weight change at 1 year on subsequent inappropriate ICD therapy during follow-up among 993 CRT-D patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy. Patients were divided into three subgroups based on weight change at 1 year after enrollment: weight loss (weight loss >= 5%), weight gain (weight gain >= 5%), and stable weight (weight loss and weight gain < 5%). The primary end point was inappropriate ICD therapy. Secondary end point included inappropriate ICD therapy related to supraventricular arrhythmias (SVAs). Results: There were 102 (10.3%) patients who experienced weight loss, 689 (69.4%) whose weight was stable, and 202 (20.3%) who gained weight at 1 year. Patients with weight loss had increased risk of subsequent inappropriate ICD therapy relative to patients with stable weight (hazard ratio [HR] = 2.35, 95% confidence interval [CI]: 1.39-3.98, P = 0.001) or weight gain (HR = 2.27, 95% CI: 1.18-4.38, P = 0.014). Furthermore, patients losing weight were at greater risk of subsequent inappropriate ICD therapy related to SVAs when compared to patients with stable weight (HR = 2.16, 95% CI: 1.18- 3.95, P = 0.013) or weight gain (HR = 2.02, 95% CI: 0.95-4.29, P = 0.068). Conclusion: In mild HF patients receiving CRT-D, significant weight loss at 1 year is associated with increased risk of subsequent inappropriate ICD therapy, including risk related to SVAs.

引用

页码：9 / 16

页数：8

共 22 条

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