Complications of implantable cardioverter-defibrillator treatment in arrhythmogenic right ventricular cardiomyopathy
(2022) In Europace 24(2). p.306-312- Abstract
Aims: Treatment with implantable cardioverter-defibrillators (ICD) is a cornerstone for prevention of sudden cardiac death in arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed at describing the complications associated with ICD treatment in a multinational cohort with long-term follow-up. Methods and results: The Nordic ARVC registry was established in 2010 and encompasses a large multinational cohort of ARVC patients, including their clinical characteristics, treatment, and events during follow-up. We included 299 patients (66% males, median age 41 years). During a median follow-up of 10.6 years, 124 (41%) patients experienced appropriate ICD shock therapy, 28 (9%) experienced inappropriate shocks, 82 (27%) had a... (More)
Aims: Treatment with implantable cardioverter-defibrillators (ICD) is a cornerstone for prevention of sudden cardiac death in arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed at describing the complications associated with ICD treatment in a multinational cohort with long-term follow-up. Methods and results: The Nordic ARVC registry was established in 2010 and encompasses a large multinational cohort of ARVC patients, including their clinical characteristics, treatment, and events during follow-up. We included 299 patients (66% males, median age 41 years). During a median follow-up of 10.6 years, 124 (41%) patients experienced appropriate ICD shock therapy, 28 (9%) experienced inappropriate shocks, 82 (27%) had a complication requiring surgery (mainly lead-related, n = 75), and 99 (33%) patients experienced the combined endpoint of either an inappropriate shock or a surgical complication. The crude rate of first inappropriate shock was 3.4% during the first year after implantation but decreased after the first year and plateaued over time. Contrary, the risk of a complication requiring surgery was 5.5% the first year and remained high throughout the study period. The combined risk of any complication was 7.9% the first year. In multivariate cox regression, presence of atrial fibrillation/flutter was a risk factor for inappropriate shock (P < 0.05), whereas sex, age at implant, and device type were not (all P > 0.05). Conclusion: Forty-one percent of ARVC patients treated with ICD experienced potentially life-saving ICD therapy during long-term follow-up. A third of the patients experienced a complication during follow-up with lead-related complications constituting the vast majority.
(Less)
- author
- organization
- publishing date
- 2022-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Arrhythmogenic right ventricular cardiomyopathy, Cardiomyopathy, Complications, Implantable cardioverter-defibrillator, Ventricular arrhythmia
- in
- Europace
- volume
- 24
- issue
- 2
- pages
- 7 pages
- publisher
- Oxford University Press
- external identifiers
-
- pmid:34279601
- scopus:85125376780
- ISSN
- 1099-5129
- DOI
- 10.1093/europace/euab112
- language
- English
- LU publication?
- yes
- id
- 1ad39a98-87f0-4e8c-aee0-d832e7b3d9c5
- date added to LUP
- 2022-04-26 15:30:21
- date last changed
- 2024-04-18 07:05:39
@article{1ad39a98-87f0-4e8c-aee0-d832e7b3d9c5,
abstract = {{<p>Aims: Treatment with implantable cardioverter-defibrillators (ICD) is a cornerstone for prevention of sudden cardiac death in arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed at describing the complications associated with ICD treatment in a multinational cohort with long-term follow-up. Methods and results: The Nordic ARVC registry was established in 2010 and encompasses a large multinational cohort of ARVC patients, including their clinical characteristics, treatment, and events during follow-up. We included 299 patients (66% males, median age 41 years). During a median follow-up of 10.6 years, 124 (41%) patients experienced appropriate ICD shock therapy, 28 (9%) experienced inappropriate shocks, 82 (27%) had a complication requiring surgery (mainly lead-related, n = 75), and 99 (33%) patients experienced the combined endpoint of either an inappropriate shock or a surgical complication. The crude rate of first inappropriate shock was 3.4% during the first year after implantation but decreased after the first year and plateaued over time. Contrary, the risk of a complication requiring surgery was 5.5% the first year and remained high throughout the study period. The combined risk of any complication was 7.9% the first year. In multivariate cox regression, presence of atrial fibrillation/flutter was a risk factor for inappropriate shock (P < 0.05), whereas sex, age at implant, and device type were not (all P > 0.05). Conclusion: Forty-one percent of ARVC patients treated with ICD experienced potentially life-saving ICD therapy during long-term follow-up. A third of the patients experienced a complication during follow-up with lead-related complications constituting the vast majority. </p>}},
author = {{Christensen, Alex Hørby and Platonov, Pyotr G. and Svensson, Anneli and Jensen, Henrik K. and Rootwelt-Norberg, Christine and Dahlberg, Pia and Madsen, Trine and Frederiksen, Tanja Charlotte and Heliö, Tiina and Haugaa, Kristina H. and Bundgaard, Henning and Svendsen, Jesper H.}},
issn = {{1099-5129}},
keywords = {{Arrhythmogenic right ventricular cardiomyopathy; Cardiomyopathy; Complications; Implantable cardioverter-defibrillator; Ventricular arrhythmia}},
language = {{eng}},
number = {{2}},
pages = {{306--312}},
publisher = {{Oxford University Press}},
series = {{Europace}},
title = {{Complications of implantable cardioverter-defibrillator treatment in arrhythmogenic right ventricular cardiomyopathy}},
url = {{http://dx.doi.org/10.1093/europace/euab112}},
doi = {{10.1093/europace/euab112}},
volume = {{24}},
year = {{2022}},
}