کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2949938 1577283 2011 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Device-Detected Atrial Tachyarrhythmias Predict Adverse Outcome in Real-World Patients With Implantable Biventricular Defibrillators
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Device-Detected Atrial Tachyarrhythmias Predict Adverse Outcome in Real-World Patients With Implantable Biventricular Defibrillators
چکیده انگلیسی

ObjectivesThe purpose of this analysis was to evaluate the correlation between atrial tachycardia (AT) or atrial fibrillation (AF) and clinical outcomes in heart failure (HF) patients implanted with a cardiac resynchronization therapy defibrillator (CRT-D).BackgroundIn HF patients, AT and AF have high prevalence and are associated with compromised hemodynamic function.MethodsForty-four Italian cardiological centers followed up 1,193 patients who received a CRT-D according to current guidelines for advanced HF, New York Heart Association functional class ≥II, left ventricular ejection fraction ≤35%, and QRS complex ≥120 ms. All patients were in sinus rhythm at implant.ResultsDuring a median follow-up period of 13 months, AT/AF >10 min occurred in 361 of 1,193 (30%) patients. The composite end point (deaths or HF hospitalizations) occurred in 174 of 1,193 (14.6%). Multivariate time-dependent Cox regression analyses showed that composite end point risk was higher among patients with device-detected AT/AF (hazard ratio [HR]: 2.16, p = 0.032), New York Heart Association functional class III or IV compared with II (HR: 2.09, p = 0.002), and absence of beta-blockers (HR: 1.36, p = 0.036). Furthermore, the composite end point risk was inversely associated with left ventricular ejection fraction (HR: 1.04, p = 0.045), increasing by a factor of 4% for each 1% decrease in left ventricular ejection fraction.ConclusionsIn HF patients with CRT-D, device-detected AT/AF is associated with a worse prognosis. Continuous device diagnostics monitoring and Web-based alerts may inform the physician of AT/AF occurrences and identify patients at risk of cardiac deterioration or patients with suboptimal rate or rhythm control. (Italian ClinicalService Project; NCT01007474)

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the American College of Cardiology - Volume 57, Issue 2, 11 January 2011, Pages 167–172
نویسندگان
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