Key result
Spironolactone as an adjunct to ICD therapy in patients with congestive heart failure reduced the number of monthly ventricular tachycardias requiring ATP.
Why the study?
Does spironolactone reduce ventricular arrhythmias and ICD therapies in patients with left ventricular systolic dysfunction and an ICD?
Cohort (n=64)
Yes
Does spironolactone reduce ventricular arrhythmias and ICD therapies in patients with left ventricular systolic dysfunction and an ICD?
The addition of spironolactone in patients with HFrEF and an ICD may reduce the burden of ventricular tachycardia requiring anti-tachycardia pacing.
Answers are grounded in this paper and cite their sources.
Spironolactone was associated with fewer monthly VT episodes requiring ATP in HF patients with ICD; hypothesis-generating and requires RCT confirmation before practice change.
AIMS/OBJECTIVES: Patients with implantable cardioverter defibrillators (ICD) often receive an adjunctive anti-arrhythmic therapy. We propose that an addition of spironolactone will reduce the number of clinically significant ventricular arrhythmias and ICD-related therapies. METHODS AND RESULTS: In a multicentre retrospective study, 64 patients with ischaemic and non-ischaemic dilated cardiomyopathy whose left ventricular ejection fraction (LVEF) was <35% and with ICD were selected. Amongst these patients, 28 patients were on spironolactone and 36 were not taking spironolactone. The ICD interrogation data were analysed for a maximum of 12 months. Wilcoxon Rank Sum test was used to compare the study and control groups. The outcomes were: (1) the number of shocks/anti-tachycardia pacing (ATP) episodes and (2) the number of episodes of ventricular tachycardia (VT) requiring ATP, non-sustained VT (NSVT), and ventricular fibrillation (VF) over the study period. The spironolactone group had fewer monthly, VTs (P=0.027) (requiring ATP). The two groups did not differ in the number of NSVT or VF per month. CONCLUSION: Addition of spironolactone as an adjunct to ICD therapy in patients with congestive heart failure (CHF) reduces VT requiring ATP, but does not affect NSVT or VF per month.
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Wase et al. (2012) conducted a cohort in Dilated cardiomyopathy with LVEF <35% and ICD (n=64). Spironolactone vs. No spironolactone was evaluated on Number of shocks/ATP episodes and episodes of VT requiring ATP, NSVT, and VF (p=0.027). Spironolactone as an adjunct to ICD therapy in patients with congestive heart failure reduced the number of monthly ventricular tachycardias requiring ATP.
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