Garcia, R;
Boveda, S;
Defaye, P;
Sadoul, N;
Narayanan, K;
Perier, M-C;
Klug, D;
... Algalarrondo, V; + view all
(2020)
Earlymortality after implantable cardioverter defibrillator: Incidence and associated factors.
International Journal of Cardiology
, 301
pp. 114-118.
10.1016/j.ijcard.2019.09.033.
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Abstract
BACKGROUND: According to guidelines, implantable cardioverter defibrillator (ICD) candidates must have a “reasonable expectation of survival with a good functional status >1 year”. Identifying risk for early mortality in ICD candidates could be challenging. We aimed to identify factors associated with a ≤1-year survival among patients implanted with ICDs. METHODS: The DAI-PP program was a multicenter, observational French study that included all patients who received a primary prevention ICD in the 2002–2012 period. Characteristics of patients who survived ≤1 year following the implantation were compared with those who survived >1 year, and predictors of early death determined. RESULTS: Out of the 5539 enrolled patients, survival status at 1 year was known for a total of 5,457, and overall 230 (4.2%) survived ≤1 year. Causes of death were similar in the two groups. Patients with ≤1-year survival had lower rates of appropriate (14 vs. 23%; P = 0.004) and inappropriate ICD therapies (2 vs. 7%; P = 0.009) than patients who lived >1 year after ICD implantation. In multivariate analysis, older age, higher NYHA class (≥III), and atrial fibrillation were significantly associated with ≤1-year survival. Presence of all 3 risk factors was associated with a cumulative 22.63% risk of death within 1 year after implantation. CONCLUSIONS: This is the largest study determining the factors predicting early mortality after ICD implantation. Patients dying within the first year had low ICD therapy rates. A combination of clinical factors could potentially identify patients at risk for early mortality to help improve selection of ICD candidates.
| Type: | Article |
|---|---|
| Title: | Earlymortality after implantable cardioverter defibrillator: Incidence and associated factors |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ijcard.2019.09.033 |
| Publisher version: | https://doi.org/10.1016/j.ijcard.2019.09.033 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions. |
| Keywords: | Implantable cardioverter defibrillator, Guideline, Mortality, Sudden cardiac death, Heart failure, Prevention |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10115530 |
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