Rusnak Jonas, Behnes Michael, Weiß Christel, Nienaber Christoph, Reiser Linda, Schupp Tobias, Bollow Armin, Taton Gabriel, Reichelt Thomas, Ellguth Dominik, Engelke Niko, Weidner Kathrin, Akin Muharrem, Mashayekhi Kambis, Borggrefe Martin, Akin Ibrahim
First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research) partner site Heidelberg/Mannheim, Mannheim, Germany.
First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research) partner site Heidelberg/Mannheim, Mannheim, Germany.
J Electrocardiol. 2020 Mar-Apr;59:174-180. doi: 10.1016/j.jelectrocard.2020.02.009. Epub 2020 Feb 21.
The study sought to assess the impact of ischemic (ICMP) compared to non-ischemic cardiomyopathy (NICMP) on recurrences of ventricular tachyarrhythmias in implantable cardioverter defibrillator (ICD) recipients.
Data comparing recurrences of ventricular tachyarrhythmias in ICD recipients with ischemic or non-ischemic cardiomyopathy is limited.
A large retrospective registry was used including all consecutive ICD recipients with first episodes of ventricular tachycardia (VT) or fibrillation (VF) from 2002 to 2016. Patients with ICMP were compared to patients with NICMP. The primary prognostic endpoint was first recurrences of ventricular tachyarrhythmias at one year. Secondary endpoints comprised ICD-related therapies, rehospitalization and all-cause mortality at one year. Statistics Kaplan-Meier survival and multivariable Cox regression analyses.
A total of 387 consecutive ICD recipients were included retrospectively (ICMP: 82%, NICMP: 18%). At one year of follow-up, freedom from first recurrences of ventricular tachyarrhythmias was lower in NICMP (81% vs. 71%, log-rank p = 0.063; HR = 1.760; 95% CI 0.985-3.002; p = 0.080), mainly attributed to higher rates of sustained VT (20% versus 12%, p = 0.054). Accordingly, freedom from first appropriate device therapies was lower in NICMP (74% vs. 85%, log rank p = 0.004; HR = 1.951; 95% CI 1.121-3.397; p = 0.028), especially in patients with sustained VT or VF at index. Both groups revealed comparable rates of rehospitalization and all-cause mortality at one year.
NICMP was associated with higher rates of recurrent ventricular tachyarrhythmias and appropriate ICD therapies compared to ICMP at one year of follow-up, whereas rates of rehospitalization and all-cause mortality were comparable.
This study retrospectively compared the impact of cardiomyopathy types (ICMP versus NICMP) on recurrences of ventricular tachyarrhythmias in 387 ICD recipients. Freedom from first episodes of ventricular tachyarrhythmias and first appropriate device therapies were lower in patients with NICMP compared to ICMP.
本研究旨在评估缺血性心肌病（ICMP）与非缺血性心肌病（NICMP）对植入式心律转复除颤器（ICD）接受者室性快速心律失常复发的影响。
比较ICD接受者中缺血性或非缺血性心肌病患者室性快速心律失常复发情况的数据有限。
使用一个大型回顾性登记数据库，纳入2002年至2016年首次发生室性心动过速（VT）或颤动（VF）的所有连续ICD接受者。将ICMP患者与NICMP患者进行比较。主要预后终点是1年时室性快速心律失常的首次复发。次要终点包括ICD相关治疗、1年时再次住院和全因死亡率。采用Kaplan-Meier生存分析和多变量Cox回归分析。
共回顾性纳入387例连续的ICD接受者（ICMP：82%，NICMP：18%）。随访1年时，NICMP患者无室性快速心律失常首次复发的比例较低（81%对71%，对数秩检验p = 0.063；HR = 1.760；95% CI 0.985 - 3.002；p = 0.080），主要归因于持续性VT发生率较高（20%对12%，p = 0.054）。因此，NICMP患者首次接受适当器械治疗的比例较低（74%对85%，对数秩检验p = 0.004；HR = 1.951；95% CI 1.121 - 3.397；p = 0.028），尤其是在初次发作时有持续性VT或VF的患者中。两组在1年时再次住院率和全因死亡率相当。
在随访1年时，与ICMP相比，NICMP与室性快速心律失常复发率和适当ICD治疗率较高相关，而再次住院率和全因死亡率相当。
本研究回顾性比较了心肌病类型（ICMP与NICMP）对387例ICD接受者室性快速心律失常复发情况的影响。与ICMP患者相比，NICMP患者无室性快速心律失常首次发作和首次接受适当器械治疗的比例较低。
