Shocks burden and increased mortality in implantable cardioverter- defibrillator patients

Gail K. Larsen, John Evans, William Lambert, Yiyi Chen, Merritt H. Raitt

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Background: Implantable cardioverter-defibrillator (ICD) shocks are associated with an increased risk of death. It is unclear whether ICD shocks are detrimental per se or a marker of higher risk patients. Objective: We aimed to assess the association between ICD shocks and time to death after correction for baseline mortality based on the Seattle Heart Failure Model (SHFM). Methods: The primary analysis compared time-to-death between patients receiving no shocks and patients receiving shocks of any type adjusted for SHFM score at time of implantation and other comorbidities. Subgroup analyses were performed to further describe the relationship between shocks and mortality risk. Results: Over a median follow-up of 41 months (interquartile range 2364), one or more shock episodes occurred in 59% of 425 patients and 40% of the patients died. Patients receiving shocks of any type had increased risk of death (hazard ratio 1.55; 95% confidence interval 1.072.23; P =.02) versus patients receiving no shocks. While patients with 15 days with shock (shock days) did not show evidence of increased risk of death (1.30 [0.881.94]; P = 0.19), those with 610 shock days (2.22 [1.214.08]; P 10 shock days (3.66 [1.867.19]; P

Original languageEnglish (US)
Pages (from-to)1881-1886
Number of pages6
JournalHeart Rhythm
Volume8
Issue number12
DOIs
StatePublished - Dec 2011

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Implantable Defibrillators
Shock
Mortality
Heart Failure
Comorbidity

Keywords

  • Antitachycardia pacing
  • Death
  • Implantable cardioverter-defibrillator
  • Shocks
  • Ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Shocks burden and increased mortality in implantable cardioverter- defibrillator patients. / Larsen, Gail K.; Evans, John; Lambert, William; Chen, Yiyi; Raitt, Merritt H.

In: Heart Rhythm, Vol. 8, No. 12, 12.2011, p. 1881-1886.

Research output: Contribution to journalArticle

Larsen, Gail K. ; Evans, John ; Lambert, William ; Chen, Yiyi ; Raitt, Merritt H. / Shocks burden and increased mortality in implantable cardioverter- defibrillator patients. In: Heart Rhythm. 2011 ; Vol. 8, No. 12. pp. 1881-1886.
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