Heart Failure and the Risk of Shocks in Patients With Implantable Cardioverter Defibrillators
Key result
Class III congestive heart failure was independently associated with an increased risk of appropriate ICD discharge for ventricular arrhythmias (HR 2.40; 95% CI 1.16-4.98).
Why the study?
Is the severity of congestive heart failure (NYHA class) associated with an increased risk of appropriate ICD discharges for VT/VF in patients with ICDs?
Population
1140 patients with implantable cardioverter-defibrillators from 31 centers in the United States, 502 with…
Comparison
Class III congestive heart failure vs Other NYHA classes or no congestive heart failure
Design
Cohort
Follow-up
median 212 days
Authors
Discussion
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Implication
NYHA Class III may aid risk stratification for appropriate ICD shocks; hypothesis-generating and requires prospective validation before guiding care.
Study Design
Type
Cohort (n=1,140)
Multicenter
Yes
Structured PICO
Is the severity of congestive heart failure (NYHA class) associated with an increased risk of appropriate ICD discharges for VT/VF in patients with ICDs?
P
Population
1140 patients with implantable cardioverter-defibrillators (ICDs) from 31 centers in the United States, 502 (44%) with baseline congestive heart failure (CHF).
I
Intervention
Class III congestive heart failure (as a risk factor)
C
Comparator
Other NYHA classes or no congestive heart failure
O
Outcome
Appropriate ICD discharges for sustained ventricular tachycardia (VT) or fibrillation (VF) confirmed by analysis of stored electrogramshard clinical
Main Result
Effect estimate: HR 2.40 (95% CI 1.16-4.98)
Class III heart failure is an independent risk factor for ventricular arrhythmias requiring shock therapy in patients with ICDs, particularly when combined with severely reduced LVEF.
Cite This Study
Whang et al. (2004) conducted a cohort in Implantable cardioverter-defibrillator (ICD) patients (n=1,140). Class III congestive heart failure vs. Other NYHA classes or no congestive heart failure was evaluated on Appropriate ICD discharges for sustained ventricular tachycardia (VT) or fibrillation (VF) (HR 2.40, 95% CI 1.16-4.98). Class III congestive heart failure was independently associated with an increased risk of appropriate ICD discharge for ventricular arrhythmias (HR 2.40; 95% CI 1.16-4.98).