Display options
Cite
Hasin T, Davarashvili I, Michowitz Y, et al. Association of Guideline-Based Medical Therapy with Malignant Arrhythmias and Mortality among Heart Failure Patients Implanted with Cardioverter Defibrillator (ICD) or Cardiac Resynchronization-Defibrillator Device (CRTD). J Clin Med. 2021;10(8)doi: 10.3390/jcm10081753.
Hasin, T., Davarashvili, I., Michowitz, Y., Farkash, R., Presman, H., Glikson, M., & Rav-Acha, M. (2021). Association of Guideline-Based Medical Therapy with Malignant Arrhythmias and Mortality among Heart Failure Patients Implanted with Cardioverter Defibrillator (ICD) or Cardiac Resynchronization-Defibrillator Device (CRTD). Journal of clinical medicine, 10(8), . https://doi.org/10.3390/jcm10081753
Hasin, Tal, et al. "Association of Guideline-Based Medical Therapy with Malignant Arrhythmias and Mortality among Heart Failure Patients Implanted with Cardioverter Defibrillator (ICD) or Cardiac Resynchronization-Defibrillator Device (CRTD)." Journal of clinical medicine vol. 10,8 (2021). doi: https://doi.org/10.3390/jcm10081753
Hasin T, Davarashvili I, Michowitz Y, Farkash R, Presman H, Glikson M, Rav-Acha M. Association of Guideline-Based Medical Therapy with Malignant Arrhythmias and Mortality among Heart Failure Patients Implanted with Cardioverter Defibrillator (ICD) or Cardiac Resynchronization-Defibrillator Device (CRTD). J Clin Med. 2021 Apr 17;10(8). doi: 10.3390/jcm10081753. PMID: 33920719; PMCID: PMC8073338.
Copy Download .nbib Format: NLM
Share it on

J Clin Med. 2021 Apr 17;10(8). doi: 10.3390/jcm10081753.

Association of Guideline-Based Medical Therapy with Malignant Arrhythmias and Mortality among Heart Failure Patients Implanted with Cardioverter Defibrillator (ICD) or Cardiac Resynchronization-Defibrillator Device (CRTD).

Journal of clinical medicine

Tal Hasin, Ilia Davarashvili, Yoav Michowitz, Rivka Farkash, Haya Presman, Michael Glikson, Moshe Rav-Acha

Affiliations

  1. Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Hebrew University, Jerusalem 9103102, Israel.
  2. Faculty of Medicine, Hebrew University, Jerusalem 9103102, Israel.

PMID: 33920719 PMCID: PMC8073338 DOI: 10.3390/jcm10081753

Abstract

AIM: Evaluate prevalence of heart failure (HF) medications and their association with ventricular arrhythmia (VA) and survival among patients implanted with primary prevention implantable cardiac defibrillator (ICD)/cardiac resynchronization therapy + defibrillator (CRTD) devices.

METHODS: Association of treatment and dose (% guideline recommended target) of beta-adrenergic receptor antagonist (BB), angiotensin-antagonists (AngA), and mineralocorticoid-antagonists (MRA), after ICD/CRTD implant with VA and mortality was retrospectively analyzed.

RESULTS: Study included 186 HF patients; 42.5% and 57.5% implanted with ICD and CRTD, respectively. During 3.8 (2.1;6.7) years; 52 (28%) had VA and 77 (41.4%) died. Treatment (% of patients) included: BB (83%), AngA (87%), and MRA (59%). Median doses were 25(12.5;50)% of target for all medications. BB treatment >25% target dose was associated with reduced VA incidence. In the multivariable model including age, gender, diabetes, heart rate, and medication doses, increased BB dose was associated with reduced VA (hazard ratio (HR) 0.443 95% CI 0.222-0.885;

CONCLUSIONS: In this cohort of real-life HF patients discharged after ICD/CRTD implant, prevalence of guideline-based HF medications was high, albeit with low doses. Higher BB dose was associated with reduced VA, while AngA was associated with improved survival.

Keywords: arrhythmia; defibrillator; heart failure; medical treatment

References

  1. J Cardiovasc Electrophysiol. 2017 May;28(5):538-543 - PubMed
  2. N Engl J Med. 1991 Aug 1;325(5):293-302 - PubMed
  3. Lancet Glob Health. 2018 Sep;6(9):e1008-e1018 - PubMed
  4. N Engl J Med. 1999 Sep 2;341(10):709-17 - PubMed
  5. Acta Cardiol. 2020 Feb;75(1):49-53 - PubMed
  6. J Am Coll Cardiol. 1999 Mar;33(3):598-604 - PubMed
  7. N Engl J Med. 2001 Dec 6;345(23):1667-75 - PubMed
  8. N Engl J Med. 2011 Jan 6;364(1):11-21 - PubMed
  9. N Engl J Med. 2002 Mar 21;346(12):877-83 - PubMed
  10. Circ Heart Fail. 2013 Mar;6(2):166-73 - PubMed
  11. Am J Cardiol. 2005 Sep 1;96(5):691-5 - PubMed
  12. Circ Res. 2011 Oct 28;109(10):1176-94 - PubMed
  13. J Am Coll Cardiol. 2018 Jul 24;72(4):351-366 - PubMed
  14. Eur Heart J. 2017 Jun 21;38(24):1883-1890 - PubMed
  15. Circ Arrhythm Electrophysiol. 2012 Aug 1;5(4):762-72 - PubMed
  16. Lancet. 2009 Nov 28;374(9704):1840-8 - PubMed
  17. J Am Coll Cardiol. 2012 Jul 17;60(3):208-15 - PubMed
  18. N Engl J Med. 2012 Dec 13;367(24):2275-83 - PubMed
  19. Lancet. 1993 Oct 2;342(8875):821-8 - PubMed
  20. PLoS One. 2012;7(11):e49203 - PubMed
  21. Eur Heart J. 2016 Jul 14;37(27):2129-2200 - PubMed
  22. BMC Cardiovasc Disord. 2013 Jul 13;13:52 - PubMed
  23. N Engl J Med. 2017 Jul 6;377(1):41-51 - PubMed
  24. Am J Cardiol. 2011 Jun 15;107(12):1812-7 - PubMed
  25. Eur Heart J. 2013 Aug;34(29):2281-329 - PubMed
  26. J Am Coll Cardiol. 2003 May 21;41(10):1707-12 - PubMed
  27. N Engl J Med. 1999 Dec 16;341(25):1882-90 - PubMed
  28. Europace. 2018 Sep 1;20(FI2):f217-f224 - PubMed
  29. Circulation. 2004 Oct 12;110(15):2180-3 - PubMed
  30. J Am Coll Cardiol. 2017 Jun 20;69(24):2885-2896 - PubMed
  31. J Am Coll Cardiol. 1998 Feb;31(2):460-72 - PubMed
  32. Europace. 2019 Sep 1;21(9):1442-1443 - PubMed
  33. N Engl J Med. 2005 Jan 20;352(3):225-37 - PubMed
  34. N Engl J Med. 2001 May 31;344(22):1651-8 - PubMed
  35. J Cardiovasc Pharmacol Ther. 2005 Jun;10 Suppl 1:S15-22 - PubMed
  36. Eur J Heart Fail. 2017 Nov;19(11):1414-1423 - PubMed
  37. Circulation. 2002 Mar 26;105(12):1453-8 - PubMed
  38. J Am Coll Cardiol. 2019 May 21;73(19):2365-2383 - PubMed
  39. N Engl J Med. 2004 May 20;350(21):2151-8 - PubMed
  40. Am J Cardiol. 1991 Jan 1;67(1):50-4 - PubMed
  41. N Engl J Med. 2016 Sep 29;375(13):1221-30 - PubMed
  42. JACC Heart Fail. 2016 Feb;4(2):109-115 - PubMed

Publication Types