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The prediction of ICD therapy in multicenter automatic defibrillator implantation trial (MADIT) II like patients: a retrospective analysis.

Budeus M, Reinsch N, Wieneke H, Sack S, Erbel R - Indian Pacing Electrophysiol J (2008)

Bottom Line: The incidence of appropriate ICD therapies did not differ significantly between the groups (group I 40%, group II 54% and group III 48% of patients).We found in group II a higher risk of appropriate ICD therapies with occurrence of a specific constellation of EPS values.The prediction of an appropriate ICD therapy with EPS was only achieved in patients with inducibility in the EPS.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, West-German Heart Centre, University of Duisburg-Essen, Germany. marco.budeus@uk-essen.de

ABSTRACT

Objectives: MADIT II like patients have not been compared to patients without an electrophysiological study, patients in whom ventricular tachycardia or fibrillation were induced in an electrophysiological study (EPS) and patients without an inducibility in EPS in one study.

Background: The multicenter automatic defibrillator implantation trial (MADIT) II showed a benefit of ICD implantation in patients with ischemic heart disease.

Methods: We performed a retrospective analysis in 93 patients with an ischemic heart disease and an ejection fraction

Results: During the mean follow-up of 32.9 +/- 16.1 months 289 appropriate ICD therapies and 10 deaths occurred. The incidence of appropriate ICD therapies did not differ significantly between the groups (group I 40%, group II 54% and group III 48% of patients). We found in group II a higher risk of appropriate ICD therapies with occurrence of a specific constellation of EPS values. These patients showed a 15-fold risk (P = 0.005) of an appropriate ICD therapy. Furthermore a brain natriuretic peptide value of 265 pg/ml also predicted an appropriate ICD therapy with a 3.5-fold risk (P = 0.017).

Conclusion: In the present retrospective study the results of MADIT II were affirmed in the case of incidence of ventricular arrhythmias in patients with an EF < 30% and coronary heart disease. The prediction of an appropriate ICD therapy with EPS was only achieved in patients with inducibility in the EPS.

No MeSH data available.


Related in: MedlinePlus

Kaplan Meier analysis for left ventricular end-diastolic volume (LVEDV ≥ 172 ml = black line, LVEDV < 172 ml = grey line)
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Figure 5: Kaplan Meier analysis for left ventricular end-diastolic volume (LVEDV ≥ 172 ml = black line, LVEDV < 172 ml = grey line)

Mentions: The Kaplan-Meier analysis did not achieve a significant difference for left ventricular end-diastolic volume ≥ 172 ml (P = 0.66) (Figure 5).


The prediction of ICD therapy in multicenter automatic defibrillator implantation trial (MADIT) II like patients: a retrospective analysis.

Budeus M, Reinsch N, Wieneke H, Sack S, Erbel R - Indian Pacing Electrophysiol J (2008)

Kaplan Meier analysis for left ventricular end-diastolic volume (LVEDV ≥ 172 ml = black line, LVEDV < 172 ml = grey line)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2267892&req=5

Figure 5: Kaplan Meier analysis for left ventricular end-diastolic volume (LVEDV ≥ 172 ml = black line, LVEDV < 172 ml = grey line)
Mentions: The Kaplan-Meier analysis did not achieve a significant difference for left ventricular end-diastolic volume ≥ 172 ml (P = 0.66) (Figure 5).

Bottom Line: The incidence of appropriate ICD therapies did not differ significantly between the groups (group I 40%, group II 54% and group III 48% of patients).We found in group II a higher risk of appropriate ICD therapies with occurrence of a specific constellation of EPS values.The prediction of an appropriate ICD therapy with EPS was only achieved in patients with inducibility in the EPS.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, West-German Heart Centre, University of Duisburg-Essen, Germany. marco.budeus@uk-essen.de

ABSTRACT

Objectives: MADIT II like patients have not been compared to patients without an electrophysiological study, patients in whom ventricular tachycardia or fibrillation were induced in an electrophysiological study (EPS) and patients without an inducibility in EPS in one study.

Background: The multicenter automatic defibrillator implantation trial (MADIT) II showed a benefit of ICD implantation in patients with ischemic heart disease.

Methods: We performed a retrospective analysis in 93 patients with an ischemic heart disease and an ejection fraction

Results: During the mean follow-up of 32.9 +/- 16.1 months 289 appropriate ICD therapies and 10 deaths occurred. The incidence of appropriate ICD therapies did not differ significantly between the groups (group I 40%, group II 54% and group III 48% of patients). We found in group II a higher risk of appropriate ICD therapies with occurrence of a specific constellation of EPS values. These patients showed a 15-fold risk (P = 0.005) of an appropriate ICD therapy. Furthermore a brain natriuretic peptide value of 265 pg/ml also predicted an appropriate ICD therapy with a 3.5-fold risk (P = 0.017).

Conclusion: In the present retrospective study the results of MADIT II were affirmed in the case of incidence of ventricular arrhythmias in patients with an EF < 30% and coronary heart disease. The prediction of an appropriate ICD therapy with EPS was only achieved in patients with inducibility in the EPS.

No MeSH data available.


Related in: MedlinePlus