Prognostic value of noninvasive programmed stimulation in patients with implantable cardioverter defibrillator

2018 ◽  
Vol 41 (12) ◽  
pp. 1643-1651
Author(s):  
Piotr Futyma ◽  
Jarosław Sander ◽  
Ryszard Głuszczyk ◽  
Marcin Maciołek ◽  
Marian Futyma ◽  
...  
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Prognostic Value ◽  
Cardioverter Defibrillator ◽  
Programmed Stimulation

scholarly journals Prognostic value of cardiovascular magnetic resonance left ventricular volumetry and geometry in patients receiving an implantable cardioverter defibrillator

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Camila M. Urzua Fresno ◽  
Luciano Folador ◽  
Tamar Shalmon ◽  
Faisal Mhd. Dib Hamad ◽  
Sheldon M. Singh ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Implantable Cardioverter Defibrillator ◽  
Prognostic Value ◽  
Outcome Data ◽  
Left Ventricular ◽  
Icd Implantation ◽  
Cardioverter Defibrillator ◽  
Lv Mass ◽  
Icd Shock

Abstract Background Current indications for implantable cardioverter defibrillator (ICD) implantation for sudden cardiac death prevention rely primarily on left ventricular (LV) ejection fraction (LVEF). Currently, two different contouring methods by cardiovascular magnetic resonance (CMR) are used for LVEF calculation. We evaluated the comparative prognostic value of these two methods in the ICD population, and if measures of LV geometry added predictive value. Methods In this retrospective, 2-center observational cohort study, patients underwent CMR prior to ICD implantation for primary or secondary prevention from January 2005 to December 2018. Two readers, blinded to all clinical and outcome data assessed CMR studies by: (a) including the LV trabeculae and papillary muscles (TPM) (trabeculated endocardial contours), and (b) excluding LV TPM (rounded endocardial contours) from the total LV mass for calculation of LVEF, LV volumes and mass. LV sphericity and sphere-volume indices were also calculated. The primary outcome was a composite of appropriate ICD shocks or death. Results Of the 372 consecutive eligible patients, 129 patients (34.7%) had appropriate ICD shock, and 65 (17.5%) died over a median duration follow-up of 61 months (IQR 38–103). LVEF was higher when including TPM versus excluding TPM (36% vs. 31%, p < 0.001). The rate of appropriate ICD shock or all-cause death was higher among patients with lower LVEF both including and excluding TPM (p for trend = 0.019 and 0.004, respectively). In multivariable models adjusting for age, primary prevention, ischemic heart disease and late gadolinium enhancement, both LVEF (HR per 10% including TPM 0.814 [95%CI 0.688–0.962] p = 0.016, vs. HR per 10% excluding TPM 0.780 [95%CI 0.639–0.951] p = 0.014) and LV mass index (HR per 10 g/m2 including TPM 1.099 [95%CI 1.027–1.175] p = 0.006; HR per 10 g/m2 excluding TPM 1.126 [95%CI 1.032–1.228] p = 0.008) had independent prognostic value. Higher LV end-systolic volumes and LV sphericity were significantly associated with increased mortality but showed no added prognostic value. Conclusion Both CMR post-processing methods showed similar prognostic value and can be used for LVEF assessment. LVEF and indexed LV mass are independent predictors for appropriate ICD shocks and all-cause mortality in the ICD population.

Abstract 12941: Long-term Prognostic Value of Cardiac Metaiodobenzylguanidine Imaging and Non-sustained Ventricular Tachycardia in Patients With Implantable Cardioverter Defibrillator

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Masato Kawasaki ◽  
Takahisa Yamada ◽  
Tetsuya Watanabe ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Implantable Cardioverter Defibrillator ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Sustained Ventricular Tachycardia ◽  
Left Ventricular Ejection ◽  
Mibg Imaging ◽  
Ventricular Tachyarrhythmias ◽  
Cardioverter Defibrillator

Background: Cardiac MIBG imaging provides prognostic information in patients with chronic heart failure (CHF). Recent studies showed that the highest occurrence of severe arrhythmic events (SAE) was seen in CHF patients with an intermediate decrease in MIBG uptake rather than the lowest values. On the other hand, non-sustained ventricular tachycardia (NSVT) has been shown to be associated with SAE in CHF patients. However, there is little information available on long-term prognostic value of intermediate decrease in MIBG up take and NSVT for the prediction of severe ventricular tachyarrhythmias in implantable cardioverter defibrillator (ICD) patients. Methods and Results: We prospectively enrolled 201 consecutive outpatients with ICD (age: 64±14 years, male: 81%, NYHA class:1.7±0.7, LVEF: 49±17%). At entry, all patients underwent cardiac MIBG imaging and 24-hour Holter electrocardiogram monitoring. An intermediate decrease in heart-to-mediastinum ratio on delayed planar image (H/M) was defined as 1.40-1.89. NSVT was defined as consecutive 3 or more beats and more than 100 bpm. During a follow-up period of 4.0±2.5 years, 59 patients had appropriate ICD discharge for severe ventricular tachyarrhythmias. At multivariate Cox regression analysis, intermediate decrease in H/M and NSVT were significantly and independently associated with appropriate ICD discharge after adjustment with age, sex and low left ventricular ejection fraction (≤35%). Appropriate ICD discharge was significantly more frequently observed in patients with both intermediate decrease in H/M and NSVT and with either intermediate decrease in H/M or NSVT than with none of them (47% vs 36% vs 14%, p<0.0001). Conclusions: Combination of cardiac MIBG imaging and NSVT would be more strongly associated with an increased risk for severe ventricular tachyarrhythmias in ICD patients.

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