TY - JOUR
T1 - Impact of Implantable Cardioverter-Defibrillator Interventions on All-Cause Mortality in Heart Failure Patients
T2 - A Meta-Analysis
AU - Bazoukis, George
AU - Tse, Gary
AU - Korantzopoulos, Panagiotis
AU - Liu, Tong
AU - Letsas, Konstantinos P.
AU - Stavrakis, Stavros
AU - Naka, Katerina K.
N1 - Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - 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.
AB - 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.
KW - antitachycardia pacing
KW - heart failure
KW - implantable cardioverter-defibrillators
KW - shocks
UR - http://www.scopus.com/inward/record.url?scp=85058021265&partnerID=8YFLogxK
U2 - 10.1097/CRD.0000000000000226
DO - 10.1097/CRD.0000000000000226
M3 - Review article
C2 - 30052536
AN - SCOPUS:85058021265
SN - 1061-5377
VL - 27
SP - 160
EP - 166
JO - Cardiology in Review
JF - Cardiology in Review
IS - 3
ER -