THE IMPACT OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS ON MORTALITY AMONG PATIENTS ON THE WAITING LIST FOR HEART-TRANSPLANTATION

被引:14
作者
GRIMM, M
WIESELTHALER, G
AVANESSIAN, R
GRIMM, G
SCHMIDINGER, H
SCHREINER, W
PODCZECK, A
WOLNER, E
LAUFER, G
机构
[1] UNIV VIENNA,DEPT INTERNAL MED 2,A-1090 VIENNA,AUSTRIA
[2] LANDESKRANKENHAUS KLAGENFURT,DEPT INTERNAL MED 2,KLAGENFURT,AUSTRIA
[3] WILHELMINENSPITAL VIENNA,DEPT INTERNAL MED 3,VIENNA,AUSTRIA
关键词
D O I
10.1016/S0022-5223(95)70251-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Implantable cardioverter-defibrillators were investigated for their impact on mortality in 228 consecutive heart transplant candidates on the waiting list for transplantation (207 patients without and 21 with implantable cardioverter-defibrillator therapy). The mortality rate in 207 patients without implantable cardioverter-defibrillator therapy was 23.2% and in 21 patients with implantable cardioverter-defibrillator therapy was 4.7%, In a Cox proportional hazards model for ail 228 study patients (mortality while on the waiting list: 21.5%; transplantation rate: 54.8%), the absence of an implantable cardioverter-defibrillator was only a marginally significant predictor of mortality (p = 0.079), However, the absence of an implantable cardioverter-defibrillator was a powerful predictor of mortality for a subgroup of 134 patients with high-grade ventricular arrhythmias on Holter electrocardiography (mortality while on the waiting list: 26.1%; transplantation rate: 54.5%; p = 0.022) and for a subgroup of 58 survivors of sudden cardiac death (mortality while on the waiting list: 22.4%; transplantation rate: 56.9%; p = 0.018), Implantable cardioverter-defibrillator therapy can be strongly recommended in transplant candidates with a history of sudden cardiac death, Recommendations for an expanded, prophylactic use of implantable cardioverter-defibrillator therapy in heart transplant candidates cannot be given.
引用
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页码:532 / 539
页数:8
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