Clinical effectiveness of primary prevention implantable cardioverter-defibrillators: results of the EU-CERT-ICD controlled multicentre cohort study.
Markus Zabel,Rik Willems,Andrzej Lubiński,Axel Bauer,Axel Bauer,Josep Brugada,David Conen,David Conen,Panagiota Flevari,Gerd Hasenfuß,Martin Svetlosak,Heikki V. Huikuri,Marek Malik,Nikola Pavlović,Georg Schmidt,Rajevaa Sritharan,Simon Schlögl,Janko Szavits-Nossan,Vassil Traykov,Anton E. Tuinenburg,Stefan N. Willich,Markus Harden,Tim Friede,Jesper Hastrup Svendsen,Jesper Hastrup Svendsen,Christian Sticherling,Béla Merkely,Eu-Cert-Icd Investigators +27 more
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In contemporary ICM/DCM patients (LVEF ≤35%, narrow QRS), primary prophylactic ICD treatment was associated with a 27% lower mortality after adjustment, and there appear to be patients with less survival advantage, such as older patients or diabetics.Abstract:
AIMS The EUropean Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter-Defibrillators (EU-CERT-ICD), a prospective investigator-initiated, controlled cohort study, was conducted in 44 centres and 15 European countries. It aimed to assess current clinical effectiveness of primary prevention ICD therapy. METHODS AND RESULTS We recruited 2327 patients with ischaemic cardiomyopathy (ICM) or dilated cardiomyopathy (DCM) and guideline indications for prophylactic ICD implantation. Primary endpoint was all-cause mortality. Clinical characteristics, medications, resting, and 12-lead Holter electrocardiograms (ECGs) were documented at enrolment baseline. Baseline and follow-up (FU) data from 2247 patients were analysable, 1516 patients before first ICD implantation (ICD group) and 731 patients without ICD serving as controls. Multivariable models and propensity scoring for adjustment were used to compare the two groups for mortality. During mean FU of 2.4 ± 1.1 years, 342 deaths occurred (6.3%/years annualized mortality, 5.6%/years in the ICD group vs. 9.2%/years in controls), favouring ICD treatment [unadjusted hazard ratio (HR) 0.682, 95% confidence interval (CI) 0.537-0.865, P = 0.0016]. Multivariable mortality predictors included age, left ventricular ejection fraction (LVEF), New York Heart Association class <III, and chronic obstructive pulmonary disease. Adjusted mortality associated with ICD vs. control was 27% lower (HR 0.731, 95% CI 0.569-0.938, P = 0.0140). Subgroup analyses indicated no ICD benefit in diabetics (adjusted HR = 0.945, P = 0.7797, P for interaction = 0.0887) or those aged ≥75 years (adjusted HR 1.063, P = 0.8206, P for interaction = 0.0902). CONCLUSION In contemporary ICM/DCM patients (LVEF ≤35%, narrow QRS), primary prophylactic ICD treatment was associated with a 27% lower mortality after adjustment. There appear to be patients with less survival advantage, such as older patients or diabetics.read more
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2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death.
Katja Zeppenfeld,Jacob Tfelt-Hansen,Marta de Riva,Bo Gregers Winkel,Elijah R. Behr,Nico A. Blom,Philippe Charron,Domenico Corrado,Nikolaos Dagres,Christian de Chillou,Lars Eckardt,Tim Friede,Kristina H. Haugaa,Mélèze Hocini,Pier D. Lambiase,Eloi Marijon,José L. Merino,Petr Peichl,Silvia G. Priori,Tobias Reichlin,Jeanette Schulz-Menger,Christian Sticherling,Stylianos Tzeis,Axel Verstrael,Maurizio Volterrani +24 more
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Effect of dapagliflozin on ventricular arrhythmias, resuscitated cardiac arrest, or sudden death in DAPA-HF
James P. Curtain,Kieran F. Docherty,Pardeep S. Jhund,Mark C. Petrie,Silvio E. Inzucchi,Lars Køber,Mikhail Kosiborod,Mikhail Kosiborod,Felipe Martinez,Piotr Ponikowski,Marc S. Sabatine,Olof Bengtsson,Anna Maria Langkilde,Mikaela Sjöstrand,Scott D. Solomon,John J.V. McMurray +15 more
TL;DR: In this paper, the effect of dapagliflozin on the incidence of ventricular arrhythmias and sudden death in patients with heart failure and reduced ejection fraction (HFrEF) was examined using Cox proportional hazards models.
Journal ArticleDOI
Predicted benefit of an implantable cardioverter-defibrillator: The MADIT-ICD benefit score
Arwa Younis,Jeffrey J. Goldberger,Valentina Kutyifa,Wojciech Zareba,Bronislava Polonsky,Helmut U. Klein,Mehmet K. Aktas,David T. Huang,James P. Daubert,Mark Estes,David S. Cannom,Scott McNitt,Kenneth M. Stein,Ilan Goldenberg +13 more
TL;DR: In this article, the MADIT-ICD benefit score was developed to predict the likelihood of prophylactic implantable cardioverter-defibrillator (ICD) benefit through personalized assessment of the risk of ventricular tachycardia (VT)/ventricular fibrillation (VF) and nonarrhythmic mortality (defined as death without prior sustained VT/VF).
Journal ArticleDOI
Fighting against sudden cardiac death: need for a paradigm shift—Adding near-term prevention and pre-emptive action to long-term prevention
TL;DR: This review challenges the current paradigm of mid- and long-term prevention using ICD in patients at the highest risk of SCD, and introduces a complementary concept applicable to the entire population that would aim to pre-empt SCD by timely detection and intervention within the minutes or hours prior to the event.
Journal ArticleDOI
Sinergy between drugs and devices in the fight against sudden cardiac death and heart failure.
Giuseppe Boriani,Roberto De Ponti,Federico Guerra,Pietro Palmisano,Gabriele Zanotto,Antonio D'Onofrio,Renato Pietro Ricci +6 more
TL;DR: In this article, the PARADIGM trial showed that the 20% relative risk reduction in cardiovascular deaths obtained with sacubitril/valsartan was attributable to reductions in the incidence of both sudden cardiac death and death due to heart failure worsening.
References
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Journal ArticleDOI
Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction.
Arthur J. Moss,Wojciech Zareba,W. Jackson Hall,Helmut U. Klein,David J. Wilber,David S. Cannom,James P. Daubert,Steven L. Higgins,Mary W. Brown,Mark L. Andrews +9 more
TL;DR: In patients with a prior myocardial infarction and advanced left ventricular dysfunction, prophylactic implantation of a defibrillator improves survival and should be considered as a recommended therapy.
Journal ArticleDOI
Amiodarone or an implantable cardioverter-defibrillator for congestive Heart failure
Gust H. Bardy,Kerry L. Lee,Daniel B. Mark,Jeanne E. Poole,Douglas L. Packer,Robin Boineau,Michael J. Domanski,Charles Troutman,Jill Anderson,Steven McNulty,Nancy E. Clapp-Channing,Linda Davidson-Ray,Elizabeth S. Fraulo,Daniel P. Fishbein,Richard M. Luceri,John Ip +15 more
TL;DR: In patients with NYHA class II or III CHF and LVEF of 35 percent or less, amiodarone has no favorable effect on survival, whereas single-lead, shock-only ICD therapy reduces overall mortality by 23 percent.
Journal ArticleDOI
2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC)
TL;DR: In this article, the authors proposed AMIOdarone versus implantable cardioverter-defibrillator (ICD-DV) for the treatment of atrial fibrillation.
Journal ArticleDOI
2015 ESC Guidelines for the Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death.
Silvia G. Priori,Carina Blomström-Lundqvist,Andrea Mazzanti,Nico A. Blom,Martin Borggrefe,John Camm,Perry M. Elliott,Donna Fitzsimons,Robert Hatala,Gerhard Hindricks,Paulus Kirchhof,Keld Kjeldsen,Karl Heinz Kuck,Antonio Hernández-Madrid,Nikolaos Nikolaou,Tone M. Norekvål,Christian Spaulding,Dirk J. van Veldhuisen +17 more
TL;DR: This poster presents a probabilistic procedure to determine the best method for selecting a single drug to treat atrial fibrillation-like symptoms in patients with a history of atrialfibrillation.
Journal ArticleDOI
Prophylactic Defibrillator Implantation in Patients with Nonischemic Dilated Cardiomyopathy
Alan H. Kadish,Alan R. Dyer,James P. Daubert,Rebecca Quigg,N.A. Mark Estes,Kelley P. Anderson,Hugh Calkins,David H Hoch,Jeffrey J. Goldberger,Alaa Shalaby,William E. Sanders,Andi Schaechter,Joseph H. Levine +12 more
TL;DR: In patients with severe, nonischemic dilated cardiomyopathy who were treated with ACE inhibitors and beta-blockers, the implantation of a cardioverter-defibrillator significantly reduced the risk of sudden death from arrhythmia and was associated with a nonsignificant reduction in the riskof death from any cause.
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2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC)
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