Why the study?
The effect of shock burden on heart failure and mortality had not been previously studied in a large population-based cohort.
Does appropriate ICD shock burden increase the risk of mortality and heart failure hospitalization in patients with an ICD?
Does appropriate ICD shock burden increase the risk of mortality and heart failure hospitalization in patients with an ICD?
Appropriate ICD shocks and recurrent shock burden are associated with increased risks of heart failure hospitalization and mortality.
Recurrent shocks may identify ICD patients needing closer HF surveillance; leaves open causality and optimal interventions.
BACKGROUND: Prior studies have demonstrated an association between appropriate implantable cardioverter defibrillator (ICD) shocks and mortality in clinical trials. The effect of shock burden on heart failure and mortality has not been previously studied in a large population-based cohort. METHODS: The cohort was derived using a comprehensive prospective ICD registry in the province of Nova Scotia with a mean follow-up of 4 ± 2.3 years. With the use of time-varying analysis, the relationship among shock burden, mortality, and heart failure hospitalization was determined. RESULTS: 0.03) compared with those receiving no ICD therapy. CONCLUSION: Ventricular arrhythmia treated with appropriate ICD shocks is associated with an increased risk of heart failure hospitalization, whereas recurrent episodes of ventricular arrhythmia requiring shocks are associated with both higher mortality and higher heart failure hospitalization rates.
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MacIntyre et al. (2019) studied this question.
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