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Death with an implantable cardioverter-defibrillator: a MADIT-II substudy

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Chernomordik, Fernando ; Jons, Christian ; Klein, Helmut U ; Kutyifa, Valentina ; Nof, Eyal ; Zareba, Wojciech ; Daubert, James P ; Greenberg, Henry ; Glikson, Michael ; Goldenberg, Ilan ; Beinart, Roy. / Death with an implantable cardioverter-defibrillator : a MADIT-II substudy. I: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2020 ; Bind 21, Nr. 12. s. 1843-1850.

Bibtex

@article{d9b99c4399074bc4bb50f1b63be849d3,
title = "Death with an implantable cardioverter-defibrillator: a MADIT-II substudy",
abstract = "AIMS: There are limited data regarding factors that identify implantable cardioverter-defibrillator (ICD) patients who will experience either ventricular tachyarrhythmic (VTA) or non-arrhythmic (NA) mortality, and the commonly used clinical classification of sudden cardiac death (SCD) vs. non-sudden cardiac death (NSCD) may not be accurate enough. We aimed to correlate clinical adjudication of mortality events to device interrogation data and to identify risk factors for VTA mortality in Multicenter Automatic Defibrillator Implantation Trial II (MADIT-II).METHODS AND RESULTS: Of the 746 patients who received an ICD in MADIT-II, 44 died from cardiac causes and had available interrogation data at the time of death. Sudden cardiac death vs. NSCD was defined by an adjudication committee. Ventricular tachyarrhythmic and NA arrhythmic deaths were categorized by the presence or absence of ventricular tachycardia or fibrillation (VT/VF) during the terminal event. Mode of death was found to be inaccurate when validated by device interrogation for VTA events: 50{\%} patients adjudicated as SCD did not have a VTA event at the time of death; and 25{\%} of adjudicated NSCD were found to have VT/VF during the mortality event. Multivariate analysis showed that factors independently associated with VTA mortality included: VT/VF >72 h prior to the mortality event [hazard ratio (HR) 8.0; P < 0.001], hospitalization for heart failure (HR 6.7; P = 0.001), and a history of hypertension (HR 4; P = 0.04).CONCLUSION: Current classification of SCD vs. NSCD fails to identify VTA events at the time of death in a significant proportion of patients, and simple clinical parameters can be used to identify ICD recipients with increased risk for VTA mortality.",
keywords = "Arrhythmic death, Implantable cardioverter-defibrillator, MADIT-II, Sudden cardiac death",
author = "Fernando Chernomordik and Christian Jons and Klein, {Helmut U} and Valentina Kutyifa and Eyal Nof and Wojciech Zareba and Daubert, {James P} and Henry Greenberg and Michael Glikson and Ilan Goldenberg and Roy Beinart",
note = "Published on behalf of the European Society of Cardiology. All rights reserved. {\circledC} The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.",
year = "2020",
doi = "10.1093/europace/euz263",
language = "English",
volume = "21",
pages = "1843--1850",
journal = "Europace",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "12",

}

RIS

TY - JOUR

T1 - Death with an implantable cardioverter-defibrillator

T2 - a MADIT-II substudy

AU - Chernomordik, Fernando

AU - Jons, Christian

AU - Klein, Helmut U

AU - Kutyifa, Valentina

AU - Nof, Eyal

AU - Zareba, Wojciech

AU - Daubert, James P

AU - Greenberg, Henry

AU - Glikson, Michael

AU - Goldenberg, Ilan

AU - Beinart, Roy

N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.

PY - 2020

Y1 - 2020

N2 - AIMS: There are limited data regarding factors that identify implantable cardioverter-defibrillator (ICD) patients who will experience either ventricular tachyarrhythmic (VTA) or non-arrhythmic (NA) mortality, and the commonly used clinical classification of sudden cardiac death (SCD) vs. non-sudden cardiac death (NSCD) may not be accurate enough. We aimed to correlate clinical adjudication of mortality events to device interrogation data and to identify risk factors for VTA mortality in Multicenter Automatic Defibrillator Implantation Trial II (MADIT-II).METHODS AND RESULTS: Of the 746 patients who received an ICD in MADIT-II, 44 died from cardiac causes and had available interrogation data at the time of death. Sudden cardiac death vs. NSCD was defined by an adjudication committee. Ventricular tachyarrhythmic and NA arrhythmic deaths were categorized by the presence or absence of ventricular tachycardia or fibrillation (VT/VF) during the terminal event. Mode of death was found to be inaccurate when validated by device interrogation for VTA events: 50% patients adjudicated as SCD did not have a VTA event at the time of death; and 25% of adjudicated NSCD were found to have VT/VF during the mortality event. Multivariate analysis showed that factors independently associated with VTA mortality included: VT/VF >72 h prior to the mortality event [hazard ratio (HR) 8.0; P < 0.001], hospitalization for heart failure (HR 6.7; P = 0.001), and a history of hypertension (HR 4; P = 0.04).CONCLUSION: Current classification of SCD vs. NSCD fails to identify VTA events at the time of death in a significant proportion of patients, and simple clinical parameters can be used to identify ICD recipients with increased risk for VTA mortality.

AB - AIMS: There are limited data regarding factors that identify implantable cardioverter-defibrillator (ICD) patients who will experience either ventricular tachyarrhythmic (VTA) or non-arrhythmic (NA) mortality, and the commonly used clinical classification of sudden cardiac death (SCD) vs. non-sudden cardiac death (NSCD) may not be accurate enough. We aimed to correlate clinical adjudication of mortality events to device interrogation data and to identify risk factors for VTA mortality in Multicenter Automatic Defibrillator Implantation Trial II (MADIT-II).METHODS AND RESULTS: Of the 746 patients who received an ICD in MADIT-II, 44 died from cardiac causes and had available interrogation data at the time of death. Sudden cardiac death vs. NSCD was defined by an adjudication committee. Ventricular tachyarrhythmic and NA arrhythmic deaths were categorized by the presence or absence of ventricular tachycardia or fibrillation (VT/VF) during the terminal event. Mode of death was found to be inaccurate when validated by device interrogation for VTA events: 50% patients adjudicated as SCD did not have a VTA event at the time of death; and 25% of adjudicated NSCD were found to have VT/VF during the mortality event. Multivariate analysis showed that factors independently associated with VTA mortality included: VT/VF >72 h prior to the mortality event [hazard ratio (HR) 8.0; P < 0.001], hospitalization for heart failure (HR 6.7; P = 0.001), and a history of hypertension (HR 4; P = 0.04).CONCLUSION: Current classification of SCD vs. NSCD fails to identify VTA events at the time of death in a significant proportion of patients, and simple clinical parameters can be used to identify ICD recipients with increased risk for VTA mortality.

KW - Arrhythmic death

KW - Implantable cardioverter-defibrillator

KW - MADIT-II

KW - Sudden cardiac death

U2 - 10.1093/europace/euz263

DO - 10.1093/europace/euz263

M3 - Journal article

VL - 21

SP - 1843

EP - 1850

JO - Europace

JF - Europace

SN - 1099-5129

IS - 12

ER -

ID: 59172423