Determinants of recurrent ventricular arrhythmia or death in 300 consecutive patients with ischemic heart disease who experienced aborted sudden death: data from the Leiden out-of-hospital cardiac arrest study. Journal of cardiovascular electrophysiology. [J Cardiovasc Electrophysiol] Journal article | | Title | Determinants of recurrent ventricular arrhythmia or death in 300 consecutive patients with ischemic heart disease who experienced aborted sudden death: data from the Leiden out-of-hospital cardiac arrest study. | | Author(s) | Kiès P, Boersma E, Bax JJ, van der Burg AE, Bootsma M, van Erven L, van der Wall EE, Schalij MJ | | Institution | Department of Cardiology, Leiden University Medical Centre, the Netherlands. | | Source | J Cardiovasc Electrophysiol 2005 Oct; 16(10):1049-56. | | MeSH | Adrenergic beta-Antagonists
Adult
Aged
Aged, 80 and over
Anti-Arrhythmia Agents
Comparative Study
Death, Sudden, Cardiac
Defibrillators, Implantable
Electrophysiologic Techniques, Cardiac
Female
Follow-Up Studies
Heart Arrest
Heart Failure, Congestive
Humans
Incidence
Male
Middle Aged
Multivariate Analysis
Myocardial Ischemia
Proportional Hazards Models
Recurrence
Stroke Volume
Survival Analysis
Tachycardia, Ventricular
Treatment Outcome
Ventricular Fibrillation
Ventricular Function, Left
| | Abstract | OBJECTIVE: Evaluation of the relation between clinical characteristics and incidence of recurrent ventricular arrhythmias (VAs) or death during long-term follow-up in a cohort of 300 consecutive ischemic heart disease (IHD) patients who had survived an episode of sudden cardiac arrest (SCA).
Background: Survivors of life-threatening VA are at high risk for recurrent events.
METHODS: A total of 300 consecutive survivors of SCA with IHD were included in a standardized screening and evaluation protocol. Multivariable Cox regression analysis was performed to determine the relation between clinical variables at baseline and the incidence of recurrent VA, all-cause mortality and the composite of both (composite endpoint).
RESULTS: The presenting arrhythmia was VT in 156 (52%) patients and VF in 144 (48%) patients. Revascularization was performed in 78 (26%) patients and an ICD was implanted in 216 (72%) patients. During follow-up (mean 30 +/- 21 months) 37 (12%) patients died and 88 (29%) patients experienced a recurrence. Advanced age (adjusted hazard ratio (HR) 2.0; 1.2-3.3), history of heart failure (HR 1.8; 1.2-2.6), and amiodarone use (HR 3.1; 2.1-4.6) were independent predictors for the composite endpoint. VT as presenting arrhythmia was an independent predictor for all-cause mortality only (HR 2.4; 1.2-4.8). A decreased risk of recurrences was determined by beta-blocker use (HR 0.5; 0.4-0.8) and coronary revascularization (HR 0.3; 0.2-0.6).
CONCLUSION: In a cohort of 300 consecutive survivors of SCA the incidence of recurrent VA and death is dependent on patient age, history of heart failure, and use of amiodarone. In contrast, use of beta-blockers and aggressive coronary revascularization improve the outcome. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 16191114 |
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