Why the study?
ICD use and indications are expanding, but technical and clinical problems continue to be encountered during implantation and follow-up.
Does diabetes mellitus increase the incidence of appropriate ICD shocks and anti-tachycardic pacing in patients with implantable cardioverter-defibrillators?
Does diabetes mellitus increase the incidence of appropriate ICD shocks and anti-tachycardic pacing in patients with implantable cardioverter-defibrillators?
Diabetic patients with ICDs experience significantly higher rates of appropriate shocks and anti-tachycardic pacing compared to non-diabetics, highlighting a higher arrhythmic burden in this population.
Diabetic ICD patients warrant closer arrhythmia surveillance; hypothesis-generating for independent risk pending adjusted analyses.
Objective: The use of permanent pacemakers and implantable cardioverter defibrillators (ICDs) is increasing. With technological advances, the devices' implantation techniques and programmable features are improving, and indications are expanding. Several technical and clinical problems are encountered during implantation and follow-up of these devices. Methods: Our study retrospectively evaluated diabetic and non-diabetic patients who underwent ICD implantation in Mersin University Cardiology Department between January 2010 and December 2013 according to current indications. All clinical characteristics, baseline, 1-month and 6-month follow-up pacemaker data and baseline laboratory values were recorded. Results: A total of 106 ICD patients (57 diabetics and 49 nondiabetics) were enrolled at the 1st and 6th months of follow-up. 47.2% of the patients were male and the mean age was 56±7.3 years. ICDs were implanted for secondary prevention in 83.9% of patients. ICD was implanted for coronary artery disease +/- ventricular tachycardia (VT) or ventricular fibrillation (VF)+/- synchronization disorder. 75.4% of patients had CAD, and 89.6% had heart failure. The mean ejection fraction ratio (EF) was 31.3%. Early complications were observed in 10.3% of patients. 47.1% of patients received any treatment by the ICD, 34.9% had the appropriate shock, and 12.2% had inappropriate shock. The complication rate was 10.3%. While there was no difference in ventricular impedance and threshold values in diabetic patients compared to the control group, ventricular lead R amplitude values were found to be higher. The rate of atrial fibrillation was significantly different in the treated group. Treatment response was obtained in 71.4% of patients who underwent treatment change due to appropriate shock, incorrect shock and ATP. Conclusion: In conclusion, the incidence of appropriate shock and anti-tachycardic pacing was higher in diabetic patients than non-diabetic patients.
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Ayhan et al. (2023) studied this question.
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