کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2922777 1175855 2012 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Implantable cardioverter-defibrillator shock prevention does not reduce mortality: A systemic review
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Implantable cardioverter-defibrillator shock prevention does not reduce mortality: A systemic review
چکیده انگلیسی

BACKGROUNDMortality is increased among implantable cardioverter-defibrillator (ICD) recipients who receive shocks; however, whether shocks cause this increase or are simply a marker of risk is unknown. Antiarrhythmic medications, catheter ablation, and enhanced ICD programming all may reduce ICD shocks, but whether shock reduction decreases mortality is unknown.OBJECTIVEThe purpose of this study was to conduct a meta-analysis to estimate the impact of ICD shock reduction on survival.METHODSTwo independent reviewers searched MEDLINE, EMBASE, and clinicaltrials.gov and extracted data from randomized controlled trials assessing the efficacy of interventions to prevent ICD shocks.RESULTSSeventeen randomized trials were included in this analysis, including 5875 patients. Mean ejection fraction of all trial participants was 32%, and 25% of the patients received ICD therapy for primary prophylaxis. Antiarrhythmic medications (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.36–0.96, P = .03) and catheter ablation of ventricular tachycardia (OR 0.35, 95% CI 0.19–0.62, P = .0004) significantly reduced the proportion of patients receiving shocks. However, there was no significant reduction in mortality among trials of antiarrhythmic medications (OR 1.07, 95% CI 0.72–1.59, P = .73) or catheter ablation (OR 0.72, 95% CI 0.32–1.64, P = .44). The 5 ICD programming trials had sufficiently heterogeneous interventions that pooling of their results was not performed. However, only the PAINFREE-II (Pacing Fast Ventricular Tachycardia Reduces Shock Therapies) trial demonstrated a significant reduction in shocks (OR 0.38, 95% CI 0.22–0.65), but this was not associated with any significant reduction in mortality (OR 1.41, 95% CI 0.81–2.45).CONCLUSIONThere is no compelling evidence that existing interventions that reduce ICD shocks significantly improve survival.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Heart Rhythm - Volume 9, Issue 12, December 2012, Pages 2068–2074
نویسندگان
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