Incidence of ventricular arrhythmic events in CKD patients with ICD.
OBJECTIVE
This study examined patients with chronic kidney disease (CKD) in stages 1, 2, 3 and 4, left ventricular dysfunction and automatic implantable cardioverter-defibrillator (ICD). Our goal was to record the appropriate therapies, "Anti-tachycardia Therapy Pacing" (ATP) and shock events during the 12months of follow-up and compare the incidence and severity of these at different stages of CKD.


METHODS
Seventy-six patients were evaluated once every three months till one year of follow-up. The arrhythmic events were assessed at each follow-up visit.


RESULTS
Comparing the groups, patients with CKD stage 4 had a higher number of ATP (45.1±4.4) and shock (33.3±5.0) events compared to other groups (P<0.0001 for both comparisons in relation to other groups). Along the 12months, 69% received ATP and 63% were treated with shock, P<0.0001 by Log-rank/Mantel-Haenszel test compared to the other groups. Regarding the ATP events, patients with CKD stage 4 showed the hazard ratio (HR) of 11.800, with a confidence interval of 95% (CI 95%) from 3.673 to 37,930, P<0.0001 vs. patients with CKD stage 1; HR of 7.957, with a CI 95% from 2.578 to 24.570, P<0.0001 vs. patients with CKD stage 2; and HR of 2.902, with a CI 95% 1.054-7.986, P=0.0391 vs. patients with CKD stage 3. In relation to the shock events, patients with CKD stage 4 showed the HR of 20,010, with a CI 95% from 5.262 to 76.080, P<0.0001 vs. patients with CKD stage 1; HR of 10.060 with a CI 95% 3.026-33.450, P=0.0001 vs. patients with CKD stage 2; and HR of 2.880, with a CI 95% 1.029-8.060, P=0.0323 vs. patients with CKD stage 3.


CONCLUSIONS
Our results suggest that the more advanced the stage of CKD higher the HR of ATP and shock events.
Divisão de Cirurgia Cardíaca, Departamento de Medicina, Hospital e Clínica São Gonçalo, São Gonçalo, RJ, Brazil; Department of Cardiology, Elisabethinen University Teaching Hospital Linz, Linz, Austria. Electronic address: marciokiuchi@gmail.com.
Márcio Galindo
MG
Kiuchi
Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Cardiology, Elisabethinen University Teaching Hospital Linz, Linz, Austria.
Shaojie
S
Chen
Department of Cardiology, Elisabethinen University Teaching Hospital Linz, Linz, Austria.
Helmut
H
Pürerfellner
D000368:Aged; D000369:Aged, 80 and over; D017147:Defibrillators, Implantable; D004554:Electric Countershock; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000175:diagnosis; D012720:Severity of Illness Index; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy
Anti-tachycardia Therapy Pacing; Automatic cardioverter defibrillator; Chronic renal disease; Shock therapy; Ventricular arrhythmias; Ventricular dysfunction