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February 1, 2018Circulation Arrhythmia and ElectrophysiologyOpen Access

Performance of the 2015 International Task Force Consensus Statement Risk Stratification Algorithm for Implantable Cardioverter-Defibrillator Placement in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

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Why the study?

The 2015 International Task Force Consensus Statement proposed a risk stratification algorithm for ICD placement in arrhythmogenic right ventricular dysplasia/cardiomyopathy, but its performance required evaluation.

Does the 2015 International Task Force Consensus Statement risk stratification algorithm accurately predict ventricular arrhythmia risk in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy?

Population

365 arrhythmogenic right ventricular dysplasia/cardiomyopathy patients

Comparison

Risk stratification by Class I, IIa, IIb, or III ICD indication per 2015 algorithm

Design

Cohort study

Follow-up

Median 4.2 years (IQR 1.7–8.4)

Authors

GOGabriela M. OrgeronARAnneline Te RieleCTCrystal Tichnell

Discussion

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Member takes

Overview

May underestimate VT/VF risk in ARVD/C; leaves open need for refined, prospectively validated stratification.

Study Design

Type

Cohort (n=365)

Structured PICO

Does the 2015 International Task Force Consensus Statement risk stratification algorithm accurately predict ventricular arrhythmia risk in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy?

P
Population
365 patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy followed for a median of 4.2 years.
E
Exposure
2015 International Task Force Consensus Statement risk stratification algorithm for implantable cardioverter-defibrillator placement
O
Outcome
Survival free from sustained ventricular arrhythmia (VT/VF) in follow-uphard clinical

Main Result

p-value: p=0.22

The 2015 International Task Force Consensus Statement algorithm for ICD placement in ARVD/C underestimates VT/VF incidence and fails to distinguish VF/flutter risks between Class I and IIa indications, suggesting a need for refinement.

Cite This Study

Orgeron et al. (2018) conducted a cohort in arrhythmogenic right ventricular dysplasia/cardiomyopathy (n=365). 2015 International Task Force Consensus Statement Risk Stratification Algorithm vs. Algorithm classes (e.g., Class I vs Class IIa) was evaluated on Survival free from sustained ventricular arrhythmia (VT/VF) (p=0.22). The 2015 International Task Force algorithm underestimated VT/VF incidence and did not differentiate VT/VF risk between Class I and IIa primary prevention patients (P=0.22).

synapsesocial.com/papers/6aacdbdc32d5c061504f8ddbhttps://doi.org/10.1161/circep.117.005593
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prophylactic Implantable Defibrillator in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia and No Prior Ventricular Fibrillation or Sustained Ventricular Tachycardia2010 · 309 citations
  2. 2Predictors of Appropriate ICD Therapy in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy: Long Term Experience of a Tertiary Care Center2012 · 38 citations
  3. 3Treatment of Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia2015 · 515 citations
  4. 4General and Disease-Specific Psychosocial Adjustment in Patients With Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy With Implantable Cardioverter Defibrillators: A Large Cohort Study2012 · 73 citations
  5. 5Different Prognostic Value of Functional Right Ventricular Parameters in Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia2014 · 109 citations