scholarly journals Primary prevention implantable cardioverter defibrillator in patients with reduced ejection fraction: for ischemic or non-ischemic cardiomyopathy or both?

2017 ◽  
Vol 9 (9) ◽  
pp. 2749-2751 ◽  
Author(s):  
Amr F. Barakat ◽  
Ahmed N. Mahmoud ◽  
Islam Y. Elgendy
Keyword(s):  
Primary Prevention ◽  
Ejection Fraction ◽  
Implantable Cardioverter Defibrillator ◽  
Ischemic Cardiomyopathy ◽  
Reduced Ejection Fraction ◽  
Cardioverter Defibrillator

scholarly journals The Effect of Sacubitril/Valsartan on Device Detected Arrhythmias and Electrical Parameters among Dilated Cardiomyopathy Patients with Reduced Ejection Fraction and Implantable Cardioverter Defibrillator

2020 ◽  
Vol 9 (4) ◽  
pp. 1111 ◽  
Author(s):  
Vincenzo Russo ◽  
Roberta Bottino ◽  
Anna Rago ◽  
Andrea Antonio Papa ◽  
Biagio Liccardo ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Implantable Cardioverter Defibrillator ◽  
Reverse Remodeling ◽  
Electrical Parameters ◽  
Pacing Threshold ◽  
Reduced Ejection Fraction ◽  
Cardioverter Defibrillator ◽  
Echocardiographic Parameters

Sacubitril/valsartan therapy reduces sudden cardiac death (SCD) among patients with reduced ejection fraction (HFrEF) when compared to guidelines recommended doses of enalapril, however the mechanism is still not clear. There are few, contrasting results about the effect of sacubitril/valsartan on arrhythmias in the clinical context of dilated cardiomyopathy (DCM) and there are no clinical data about its effect on measured implantable cardioverter defibrillator (ICD) electrical parameters, such as atrial/ventricular electrograms sensing and pacing threshold. We conducted a 12 month follow-up observational study in 167 ischemic and nonischemic DCM patients (mean age 68.1 ± 11.6 years; 85% male), with dual-chamber ICD on sacubitril/valsartan treatment, to evaluate the incidence of device detected tachyarrhythmia events, both atrial and ventricular, and the change in measured ICD electrical parameters. We collected data on clinical, electrocardiographic and echocardiographic parameters to find a possible electro-mechanical correlation within results. Our results show that DCM patients with reduced ejection fraction and ICD on sacubitril/valsartan treatment experienced a reduction in both atrial and ventricular arrhythmias incidence and an improvement in ICD electrical atrial parameters. The findings might be explained by the electro-mechanical cardiac reverse remodeling induced by sacubitril/valsartan therapy.

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