Predictors and Clinical Impact of Inappropriate Implantable Cardioverter-Defibrillator Shocks in Korean Patients.
10.3346/jkms.2012.27.6.619
- Author:
Jeong Hoon YANG
1
;
Kyeongmin BYEON
;
Hye Ran YIM
;
Jung Wae PARK
;
Seung Jung PARK
;
June HUH
;
June Soo KIM
;
Young Keun ON
Author Information
1. Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yk.on@samsung.com
- Publication Type:Original Article
- Keywords:
Implantable Cardioverter-Defibrillator;
Inappropriate Shock
- MeSH:
Adult;
Aged;
Atrial Fibrillation/complications;
Defibrillators, Implantable/*adverse effects;
Equipment Failure;
Female;
Hospitalization;
Humans;
Kaplan-Meier Estimate;
Male;
Middle Aged;
*Predictive Value of Tests;
Republic of Korea;
Retrospective Studies;
Risk Factors;
Shock/*etiology/mortality;
Tachycardia, Supraventricular/complications
- From:Journal of Korean Medical Science
2012;27(6):619-624
- CountryRepublic of Korea
- Language:English
-
Abstract:
Limited data are available on inappropriate shocks in Korean patients implanted with an implantable cardioverter-defibrillator (ICD). We investigated the impact of inappropriate shocks on clinical outcomes. This retrospective, single-center study included 148 patients treated between October 1999 and June 2011. The primary outcome was a composite event of all-cause mortality or hospitalization for any cardiac reason. The median follow-up duration was 29 months (interquartile range: 8 to 53). One or more inappropriate shocks occurred in 34 (23.0%) patients. A history of atrial fibrillation was the only independent predictor of inappropriate shock (hazard ratio [HR]: 4.16, 95% confidence interval [CI]: 1.89-9.15, P < 0.001). Atrial fibrillation was the most common cause of inappropriate shock (67.7%), followed by supraventricular tachycardia (23.5%), and abnormal sensing (8.8%). A composite event of all-cause mortality or hospitalizations for any cardiac reason during follow-up was not significantly different between patients with or without inappropriate shock (inappropriate shock vs no inappropriate shock: 35.3% vs 35.4%, adjusted HR: 1.06, 95% CI: 0.49-2.29, P = 0.877). Inappropriate shocks do not affect clinical outcomes in patients implanted with an ICD, although the incidence of inappropriate shocks is high.
