Key result
Inappropriate implantable cardioverter-defibrillator shocks did not significantly affect the composite of all-cause mortality or cardiac hospitalization (adjusted HR 1.06) compared to no inappropriate shocks.
Why the study?
Does the occurrence of inappropriate ICD shocks increase the composite of all-cause mortality or cardiac hospitalization in patients implanted with an ICD?
Observational (n=148)
No
Does the occurrence of inappropriate ICD shocks increase the composite of all-cause mortality or cardiac hospitalization in patients implanted with an ICD?
Effect estimate: HR 1.06 (95% CI 0.49-2.29)
Absolute Event Rate: 35.3% vs 25.4%
p-value: p=0.877
Inappropriate ICD shocks, while common and primarily driven by atrial fibrillation, did not significantly impact long-term mortality or cardiac hospitalization in this Korean cohort.
Reassures against altering management for inappropriate ICD shocks alone; leaves open causal effects in broader populations.
Limited data are available on inappropriate shocks in Korean patients implanted with an implantable cardioverter-defibrillator (ICD). We investigated the impact of inappropriate shocks on clinical outcomes. This retrospective, single-center study included 148 patients treated between October 1999 and June 2011. The primary outcome was a composite event of all-cause mortality or hospitalization for any cardiac reason. The median follow-up duration was 29 months (interquartile range: 8 to 53). One or more inappropriate shocks occurred in 34 (23.0%) patients. A history of atrial fibrillation was the only independent predictor of inappropriate shock (hazard ratio [HR]: 4.16, 95% confidence interval [CI]: 1.89-9.15, P < 0.001). Atrial fibrillation was the most common cause of inappropriate shock (67.7%), followed by supraventricular tachycardia (23.5%), and abnormal sensing (8.8%). A composite event of all-cause mortality or hospitalizations for any cardiac reason during follow-up was not significantly different between patients with or without inappropriate shock (inappropriate shock vs no inappropriate shock: 35.3% vs 35.4%, adjusted HR: 1.06, 95% CI: 0.49-2.29, P = 0.877). Inappropriate shocks do not affect clinical outcomes in patients implanted with an ICD, although the incidence of inappropriate shocks is high.
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Yang et al. (2012) conducted an observational in Implantable cardioverter-defibrillator (ICD) recipients (n=148). Inappropriate ICD shock vs. No inappropriate ICD shock was evaluated on Composite of all-cause mortality or hospitalization for any cardiac reason (HR 1.06, 95% CI 0.49-2.29, p=0.877). Inappropriate implantable cardioverter-defibrillator shocks did not significantly affect the composite of all-cause mortality or cardiac hospitalization (adjusted HR 1.06) compared to no inappropriate shocks.
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