Predictors and clinical impact of inappropriate implantable cardioverter-defibrillator shocks in Korean patients.
Limited data are available on inappropriate shocks in Korean patients implanted with an implantable cardioverter-defibrillator (ICD). We investigated the impact of inappropriate shocks on clinical outcomes. This retrospective, single-center study included 148 patients treated between October 1999 and June 2011. The primary outcome was a composite event of all-cause mortality or hospitalization for any cardiac reason. The median follow-up duration was 29 months (interquartile range: 8 to 53). One or more inappropriate shocks occurred in 34 (23.0%) patients. A history of atrial fibrillation was the only independent predictor of inappropriate shock (hazard ratio [HR]: 4.16, 95% confidence interval [CI]: 1.89-9.15, P < 0.001). Atrial fibrillation was the most common cause of inappropriate shock (67.7%), followed by supraventricular tachycardia (23.5%), and abnormal sensing (8.8%). A composite event of all-cause mortality or hospitalizations for any cardiac reason during follow-up was not significantly different between patients with or without inappropriate shock (inappropriate shock vs no inappropriate shock: 35.3% vs 35.4%, adjusted HR: 1.06, 95% CI: 0.49-2.29, P = 0.877). Inappropriate shocks do not affect clinical outcomes in patients implanted with an ICD, although the incidence of inappropriate shocks is high.
Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jeong Hoon
JH
Yang
Kyeongmin
K
Byeon
Hye Ran
HR
Yim
Jung Wae
JW
Park
Seung-Jung
SJ
Park
June
J
Huh
June Soo
JS
Kim
Young Keun
YK
On
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D012769:Shock / Q000209:etiology* / Q000401:mortality; D013617:Tachycardia, Supraventricular / Q000150:complications