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Implantable cardioverter-defibrillators in hypertrophic cardiomyopathy: patient outcomes, rate of appropriate and inappropriate interventions, and complications

(2013) AMERICAN HEART JOURNAL. 166(3). p.496-502
Author
Organization
Abstract
Background: Sudden cardiac death (SCD) is the most devastating complication of hypertrophic cardiomyopathy (HCM), but this can be prevented by an implantable cardioverter-defibrillator (ICD). The aim of this study is to evaluate HCM patients with ICDs for primary or secondary prevention of SCD. Methods: The study population consisted of all HCM patients with an ICD in 2 tertiary referral clinics. End points during follow-up were total and cardiac mortality, appropriate and inappropriate ICD intervention, and device-related complications. Cox-regression analysis was performed to identify predictors of outcome. Results: ICDs were implanted in 134 patients with HCM (mean age 44 +/- 17 years, 34% women, 4.2 +/- 4.8 years follow-up). Annualized cardiac mortality rate was 3.4% per year and associated with New York Heart Association class III or IV (HR 5.2 [2.0-14, P = .002]) and cardiac resynchronization therapy (HR 6.3 [2.1-20, P = .02]). Appropriate ICD interventions occurred in 38 patients (6.8%/year) and was associated with implantation for secondary prevention of SCD (HR 4.0 [1.89.1], P = .001) and male gender (HR 3.3 [1.2-9.0], P = .02). Inappropriate ICD intervention occurred in 21 patients ( 3.7%/year) and in 20 patients device related complications were documented (3.6%/year). Conclusion: ICDs successfully abort life-threatening arrhythmias in HCM patients at increased risk of SCD with an annualized intervention rate of 6.8% per year. End-stage heart failure is the main cause of mortality in these patients. The annualized rate of inappropriate ICD intervention was 3.7% per year, whereas device-related complications occurred 3.6% per year.
Keywords
TERM-FOLLOW-UP, SUDDEN CARDIAC DEATH, RISK STRATIFICATION, EUROPEAN-SOCIETY, THERAPY, PREVENTION, EFFICACY, GUIDELINES, SURVIVAL, ABLATION

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MLA
Vriesendorp, Pieter A et al. “Implantable Cardioverter-defibrillators in Hypertrophic Cardiomyopathy: Patient Outcomes, Rate of Appropriate and Inappropriate Interventions, and Complications.” AMERICAN HEART JOURNAL 166.3 (2013): 496–502. Print.
APA
Vriesendorp, P. A., Schinkel, A. F., Van Cleemput, J., Willems, R., Jordaens, L., Theuns, D. A., van Slegtenhorst, M. A., et al. (2013). Implantable cardioverter-defibrillators in hypertrophic cardiomyopathy: patient outcomes, rate of appropriate and inappropriate interventions, and complications. AMERICAN HEART JOURNAL, 166(3), 496–502.
Chicago author-date
Vriesendorp, Pieter A, Arend FL Schinkel, Johan Van Cleemput, Rik Willems, Luc Jordaens, Dominic AMJ Theuns, Marjon A van Slegtenhorst, Thomy J de Ravel, Folkert J ten Cate, and Michelle Michels. 2013. “Implantable Cardioverter-defibrillators in Hypertrophic Cardiomyopathy: Patient Outcomes, Rate of Appropriate and Inappropriate Interventions, and Complications.” American Heart Journal 166 (3): 496–502.
Chicago author-date (all authors)
Vriesendorp, Pieter A, Arend FL Schinkel, Johan Van Cleemput, Rik Willems, Luc Jordaens, Dominic AMJ Theuns, Marjon A van Slegtenhorst, Thomy J de Ravel, Folkert J ten Cate, and Michelle Michels. 2013. “Implantable Cardioverter-defibrillators in Hypertrophic Cardiomyopathy: Patient Outcomes, Rate of Appropriate and Inappropriate Interventions, and Complications.” American Heart Journal 166 (3): 496–502.
Vancouver
1.
Vriesendorp PA, Schinkel AF, Van Cleemput J, Willems R, Jordaens L, Theuns DA, et al. Implantable cardioverter-defibrillators in hypertrophic cardiomyopathy: patient outcomes, rate of appropriate and inappropriate interventions, and complications. AMERICAN HEART JOURNAL. 2013;166(3):496–502.
IEEE
[1]
P. A. Vriesendorp et al., “Implantable cardioverter-defibrillators in hypertrophic cardiomyopathy: patient outcomes, rate of appropriate and inappropriate interventions, and complications,” AMERICAN HEART JOURNAL, vol. 166, no. 3, pp. 496–502, 2013.
@article{8101284,
  abstract     = {Background: Sudden cardiac death (SCD) is the most devastating complication of hypertrophic cardiomyopathy (HCM), but this can be prevented by an implantable cardioverter-defibrillator (ICD). The aim of this study is to evaluate HCM patients with ICDs for primary or secondary prevention of SCD. 
Methods: The study population consisted of all HCM patients with an ICD in 2 tertiary referral clinics. End points during follow-up were total and cardiac mortality, appropriate and inappropriate ICD intervention, and device-related complications. Cox-regression analysis was performed to identify predictors of outcome. 
Results: ICDs were implanted in 134 patients with HCM (mean age 44 +/- 17 years, 34% women, 4.2 +/- 4.8 years follow-up). Annualized cardiac mortality rate was 3.4% per year and associated with New York Heart Association class III or IV (HR 5.2 [2.0-14, P = .002]) and cardiac resynchronization therapy (HR 6.3 [2.1-20, P = .02]). Appropriate ICD interventions occurred in 38 patients (6.8%/year) and was associated with implantation for secondary prevention of SCD (HR 4.0 [1.89.1], P = .001) and male gender (HR 3.3 [1.2-9.0], P = .02). Inappropriate ICD intervention occurred in 21 patients ( 3.7%/year) and in 20 patients device related complications were documented (3.6%/year). 
Conclusion: ICDs successfully abort life-threatening arrhythmias in HCM patients at increased risk of SCD with an annualized intervention rate of 6.8% per year. End-stage heart failure is the main cause of mortality in these patients. The annualized rate of inappropriate ICD intervention was 3.7% per year, whereas device-related complications occurred 3.6% per year.},
  author       = {Vriesendorp, Pieter A and Schinkel, Arend FL and Van Cleemput, Johan and Willems, Rik and Jordaens, Luc and Theuns, Dominic AMJ and van Slegtenhorst, Marjon A and de Ravel, Thomy J and ten Cate, Folkert J and Michels, Michelle},
  issn         = {0002-8703},
  journal      = {AMERICAN HEART JOURNAL},
  keywords     = {TERM-FOLLOW-UP,SUDDEN CARDIAC DEATH,RISK STRATIFICATION,EUROPEAN-SOCIETY,THERAPY,PREVENTION,EFFICACY,GUIDELINES,SURVIVAL,ABLATION},
  language     = {eng},
  number       = {3},
  pages        = {496--502},
  title        = {Implantable cardioverter-defibrillators in hypertrophic cardiomyopathy: patient outcomes, rate of appropriate and inappropriate interventions, and complications},
  url          = {http://dx.doi.org/10.1016/j.ahj.2013.06.009},
  volume       = {166},
  year         = {2013},
}

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