Implantable cardioverter defibrillator - powerful weapon in primary and secondary prevention of sudden cardiac death
Bacgraund/Aim. Sudden cardiac death (SCD) is one of the biggest problems of the contemporary medicine. Large studies showed that anti-arrhythmics, including amiodarone, are not effective in prevention of SCD in the patients with cardiac diseases who were on drug treatment. Those patients who receive...
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Military Health Department, Ministry of Defance, Serbia
2019-01-01
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doaj-30e2bde930af4d6dae2812fc56909e062020-11-25T02:19:40ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502406-07202019-01-0176101007101310.2298/VSP171003010K0042-84501800010KImplantable cardioverter defibrillator - powerful weapon in primary and secondary prevention of sudden cardiac deathKostić Tomislav0Stanojević Dragana1Gudelj Ognjen2Milić Dragan3Putnik Svetozar4Perišić Zoran5Đinčić Boris6Pavlović Milan7Koraćević Goran8Golubović Mlaċan9Mitov Vladimir10Momčilović Stefan11Banković Sanja12Clinical Centre Niš, Clinic for Cardiovascular Diseases, Niš, SerbiaMilitary Medical Academy, Clinic for Cardiology, Belgrade, SerbiaMilitary Medical Academy, Clinic for Cardiology, Belgrade, SerbiaClinical Centre of Serbia, Clinic for Cardiac Surgery, Belgrade, SerbiaClinical Centre of Serbia, Clinic for Cardiac Surgery, Belgrade, SerbiaClinical Centre Niš, Clinic for Cardiovascular Diseases, Niš, SerbiaClinical Centre Niš, Clinic for Cardiovascular Diseases, Niš, SerbiaClinical Centre Niš, Clinic for Cardiovascular Diseases, Niš, SerbiaClinical Centre Niš, Clinic for Cardiovascular Diseases, Niš, SerbiaClinical Centre Niš, Clinic for Cardiothoracic and Transplantation Surgery, Niš, SerbiaHealth Centre Zaječar, SerbiaClinical Centre Niš, Clinic for Cardiovascular Diseases, Niš, SerbiaClinical Centre Niš, Clinic for Cardiovascular Diseases, Niš, SerbiaBacgraund/Aim. Sudden cardiac death (SCD) is one of the biggest problems of the contemporary medicine. Large studies showed that anti-arrhythmics, including amiodarone, are not effective in prevention of SCD in the patients with cardiac diseases who were on drug treatment. Those patients who received implantable cardioverter defibrillators (ICD) had better survival. The aim of this paper was to determine whether the patients receiving the ICD in the primary and secondary SCD prevention have longer survival than the patients treated exclusively with drug therapy. Methods. We included 1,260 patients with cardiac insufficiency and reduced left ventricular ejection fraction (LVEF < 35%) who were at high risk for malignant ventricular arrhythmias and SCD. Five hundred forty patients received ICD therapy. The cardiac resynchronization therapy – CRT/ICD group (n = 270) comprised the patients with cardiac insufficiency and CRT/ICD pacemaker at an optimal medical therapy. In the control group (n = 450), there were the patients with cardiac insufficiency (NYHA functional class 3–4, LVEF ≤ 35%, QRS duration ≥ 130 ms), at optimum drug therapy. Results. In the ICD group, there was a statistically significant increase in end-systolic volume (ESV) from 92.68 mL to 99.05 mL. In the group of patients with cardiac insufficiency who were on drug therapy, there was a significant decrease in LVEF (33.15% vs. 30.2%; p = 0.017), 6-minute walk distance (6 MWT distance) (216.55 m vs. 203.27 m, p = 0.003). In the same group, there was an increase in the values of ESV (90.19 mL vs. 95.41 mL; p = 0.011). An increase in the mortality rate in the group of patients with drug therapy compared to the CRT/ICD and ICD groups was statistically significant (p < 0.05). Conclusions. An ICD pacemaker implantation significantly reduces mortality compared to medical therapy only. In addition, the patients who have CRT in addition to ICD pacemaker, have a significantly better quality of life and increase in LVEF.http://www.doiserbia.nb.rs/img/doi/0042-8450/2019/0042-84501800010K.pdfdeath, sudden, cardiacarrhythmias, cardiacheart failuredefibrillators, implantabledrug therapypacemaker, artificialmortality |
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language |
English |
format |
Article |
sources |
DOAJ |
author |
Kostić Tomislav Stanojević Dragana Gudelj Ognjen Milić Dragan Putnik Svetozar Perišić Zoran Đinčić Boris Pavlović Milan Koraćević Goran Golubović Mlaċan Mitov Vladimir Momčilović Stefan Banković Sanja |
spellingShingle |
Kostić Tomislav Stanojević Dragana Gudelj Ognjen Milić Dragan Putnik Svetozar Perišić Zoran Đinčić Boris Pavlović Milan Koraćević Goran Golubović Mlaċan Mitov Vladimir Momčilović Stefan Banković Sanja Implantable cardioverter defibrillator - powerful weapon in primary and secondary prevention of sudden cardiac death Vojnosanitetski Pregled death, sudden, cardiac arrhythmias, cardiac heart failure defibrillators, implantable drug therapy pacemaker, artificial mortality |
author_facet |
Kostić Tomislav Stanojević Dragana Gudelj Ognjen Milić Dragan Putnik Svetozar Perišić Zoran Đinčić Boris Pavlović Milan Koraćević Goran Golubović Mlaċan Mitov Vladimir Momčilović Stefan Banković Sanja |
author_sort |
Kostić Tomislav |
title |
Implantable cardioverter defibrillator - powerful weapon in primary and secondary prevention of sudden cardiac death |
title_short |
Implantable cardioverter defibrillator - powerful weapon in primary and secondary prevention of sudden cardiac death |
title_full |
Implantable cardioverter defibrillator - powerful weapon in primary and secondary prevention of sudden cardiac death |
title_fullStr |
Implantable cardioverter defibrillator - powerful weapon in primary and secondary prevention of sudden cardiac death |
title_full_unstemmed |
Implantable cardioverter defibrillator - powerful weapon in primary and secondary prevention of sudden cardiac death |
title_sort |
implantable cardioverter defibrillator - powerful weapon in primary and secondary prevention of sudden cardiac death |
publisher |
Military Health Department, Ministry of Defance, Serbia |
series |
Vojnosanitetski Pregled |
issn |
0042-8450 2406-0720 |
publishDate |
2019-01-01 |
description |
Bacgraund/Aim. Sudden cardiac death (SCD) is one of the biggest problems of the contemporary medicine. Large studies showed that anti-arrhythmics, including amiodarone, are not effective in prevention of SCD in the patients with cardiac diseases who were on drug treatment. Those patients who received implantable cardioverter defibrillators (ICD) had better survival. The aim of this paper was to determine whether the patients receiving the ICD in the primary and secondary SCD prevention have longer survival than the patients treated exclusively with drug therapy. Methods. We included 1,260 patients with cardiac insufficiency and reduced left ventricular ejection fraction (LVEF < 35%) who were at high risk for malignant ventricular arrhythmias and SCD. Five hundred forty patients received ICD therapy. The cardiac resynchronization therapy – CRT/ICD group (n = 270) comprised the patients with cardiac insufficiency and CRT/ICD pacemaker at an optimal medical therapy. In the control group (n = 450), there were the patients with cardiac insufficiency (NYHA functional class 3–4, LVEF ≤ 35%, QRS duration ≥ 130 ms), at optimum drug therapy. Results. In the ICD group, there was a statistically significant increase in end-systolic volume (ESV) from 92.68 mL to 99.05 mL. In the group of patients with cardiac insufficiency who were on drug therapy, there was a significant decrease in LVEF (33.15% vs. 30.2%; p = 0.017), 6-minute walk distance (6 MWT distance) (216.55 m vs. 203.27 m, p = 0.003). In the same group, there was an increase in the values of ESV (90.19 mL vs. 95.41 mL; p = 0.011). An increase in the mortality rate in the group of patients with drug therapy compared to the CRT/ICD and ICD groups was statistically significant (p < 0.05). Conclusions. An ICD pacemaker implantation significantly reduces mortality compared to medical therapy only. In addition, the patients who have CRT in addition to ICD pacemaker, have a significantly better quality of life and increase in LVEF. |
topic |
death, sudden, cardiac arrhythmias, cardiac heart failure defibrillators, implantable drug therapy pacemaker, artificial mortality |
url |
http://www.doiserbia.nb.rs/img/doi/0042-8450/2019/0042-84501800010K.pdf |
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