Impact of Implantable Cardioverter-Defibrillator Interventions on All-Cause Mortality in Heart Failure Patients: A Meta-Analysis

George Bazoukis, Gary Tse, Panagiotis Korantzopoulos, Tong Liu, Konstantinos P. Letsas, Stavros Stavrakis, Katerina K. Naka

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)

Abstract

Implantable cardioverter-defibrillators (ICDs) have a unique role in the primary and secondary prevention of sudden cardiac death. However, appropriate and inappropriate ICD interventions [antitachycardia pacing (ATP) or shocks] can result in deleterious effects. The aim of our study was to systematically review the existing data about the impact of ICD interventions on all-cause mortality in heart failure patients with reduced ejection fraction (HFrEF). We systematically searched MEDLINE (by using PubMed Web-based search engine) without any limits until September 30, 2017. After screening 17,752 records, a total of 17 studies met our inclusion criteria and were included in our meta-analysis. Our data showed that in patients with HFrEF, appropriate [hazard ratio (HR), 2.00; 95% confidence interval (CI), 1.52-2.63; P < 0.01; I2 88%] and inappropriate [HR, 1.30; 95% CI, 1.07-1.58; P < 0.01; I2 26%] ICD interventions were significantly associated with increased all-cause mortality. However, neither appropriate ATP [HR, 1.27; 95% CI, 0.80-2.02; P = 0.30; I2 62%] nor inappropriate ATP [HR, 1.01; 95% CI, 0.49-2.07; P = 0.98; I2 46%] were significantly associated with all-cause mortality in this patient population. In conclusion, ICD shocks are associated with a worse prognosis in HFrEF.

Original languageEnglish
Pages (from-to)160-166
Number of pages7
JournalCardiology in Review
Volume27
Issue number3
DOIs
Publication statusPublished - 1 May 2019
Externally publishedYes

Keywords

  • antitachycardia pacing
  • heart failure
  • implantable cardioverter-defibrillators
  • shocks

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