title: Effect of spironolactone on ventricular arrhythmias in patients with left ventricular systolic dysfunction and implantable cardioverter defibrillators.
abstract: OBJECTIVE
  Patients with implantable cardioverter defibrillators (ICD) often receive an adjunctive anti-arrhythmic therapy. We propose that an addition of spironolactone will reduce the number of clinically significant ventricular arrhythmias and ICD-related therapies.
  
  
  RESULTS
  In a multicentre retrospective study, 64 patients with ischaemic and non-ischaemic dilated cardiomyopathy whose left ventricular ejection fraction (LVEF) was <35% and with ICD were selected. Amongst these patients, 28 patients were on spironolactone and 36 were not taking spironolactone. The ICD interrogation data were analysed for a maximum of 12 months. Wilcoxon Rank Sum test was used to compare the study and control groups. The outcomes were: (1) the number of shocks/anti-tachycardia pacing (ATP) episodes and (2) the number of episodes of ventricular tachycardia (VT) requiring ATP, non-sustained VT (NSVT), and ventricular fibrillation (VF) over the study period. The spironolactone group had fewer monthly, VTs (P=0.027) (requiring ATP). The two groups did not differ in the number of NSVT or VF per month.
  
  
  CONCLUSIONS
  Addition of spironolactone as an adjunct to ICD therapy in patients with congestive heart failure (CHF) reduces VT requiring ATP, but does not affect NSVT or VF per month.
authors.affiliation: Good Samaritan Heart and Vascular Hospital, Dayton, OH, USA. abdul.wase@wright.edu
authors.forename: Abdul
authors.initials: A
authors.lastname: Wase
authors.forename: Naga
authors.initials: N
authors.lastname: Garikipati
authors.forename: Omar
authors.initials: O
authors.lastname: Mufti
authors.forename: Zulfiqar
authors.initials: Z
authors.lastname: Mirza
authors.forename: Aparna
authors.initials: A
authors.lastname: Innaparthy
authors.forename: Anwarul
authors.initials: A
authors.lastname: Kabir
authors.forename: Mohammed B
authors.initials: MB
authors.lastname: Quraishi
authors.forename: Ronald
authors.initials: R
authors.lastname: Markert
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000494:pharmacology*; D012189:Retrospective Studies; D013148:Spironolactone / Q000494:pharmacology*; D018487:Ventricular Dysfunction, Left / Q000150:complications*
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone