title: [Predictive parameters of occurrence of adequate interventions in patients with implanted cardioverter-defibrillators with or without resynchronisation therapy in primary prevention of sudden cardiac death in dilated cardiomyopathy].
abstract: The task of the ICD is to detect ventricular arrhythmias and treatment of its adequate intervention. The task of the CRTD in addition to the above tasks is the treatment of heart failure.
  
  
  OBJECTIVE
  The aim of the study was to assess the predictive parameters of adequate interventions in patients with an ICD and CRTD.
  
  
  METHODS
  The study consisted of 273 patients (230 M, mean age 65±11 years) with ICD and/or CRTD. The inclusion criteria were: left ventricle ejection fraction (LVEF) ≤ 35%, NYHA class ≥ II, implantation in primary SCD prevention and in case of CRTD additionally LBBB with wide QRS ≥ 120ms. The following data were assessed: age, gender, presence of dilated cardiomyopathy, diabetes, chronic kidney failure, atrial fibrillation (AF), LVEF, NYHA class, device interventions, number of arrhythmias, changes in pharmacotherapy, device parameters and mortality.
  
  
  RESULTS
  During observation, which lasted the mean of 770±490 days, 102 patients had adequate device interventions. In the ICD group, adequate interventions appear mainly in the initial observation period (HR 2,01), in patients with left ventricular hypertrophy (HR 2,98) and ventricular arrhythmias (HR 6,78) and not treated with amiodarone (HR 4,31). In the CRTD group, adequate interventions appear mainly in younger patients (HR 1,06), in diabetes (HR 1,68), in NYHA class II, in paroxysmal atrial fibrillation (HR 1,09) and ventricular arrhythmias (HR 2,54) and not treated with amiodarone (HR 1,09).
  
  
  CONCLUSIONS
  In the ICD group, left ventricular hypertrophy, ventricular arrhythmias is not treated with amiodarone in a significant influence on the risk of adequate intervention. In the Group of CRTD younger age, diabetes, NYHA class II, paroxysmal atrial fibrillation, ventricular arrhythmias is not treated with amiodarone in a significant influence on the risk of adequate intervention. In the ICD group, adequate interventions particularly often in the first year of follow-up. Patients with CRTD require special medical care.
authors.affiliation: Jagiellonian University, Institute of Cardiology, Department of Electrocardiology, The John Paul II Hospital in Kraków.
authors.forename: Jacek
authors.initials: J
authors.lastname: Lelakowski
authors.affiliation: Jagiellonian University, Institute of Cardiology, Department of Electrocardiology, The John Paul II Hospital in Kraków.
authors.forename: Anna
authors.initials: A
authors.lastname: Rydlewska
authors.affiliation: Department of Coronary Disease and Heart Failure, The John Paul II Hospital in Kraków.
authors.forename: Maria
authors.initials: M
authors.lastname: Lelakowska
authors.affiliation: Jagiellonian University, Institute of Cardiology, Department of Electrocardiology, The John Paul II Hospital in Kraków.
authors.forename: Joanna
authors.initials: J
authors.lastname: Pudło
authors.affiliation: Department of Electrocardiology, The John Paul II Hospital in Kraków.
authors.forename: Justyna
authors.initials: J
authors.lastname: Piekarz
mesh_terms: D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000628:therapy*; D058406:Cardiac Resynchronization Therapy; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000628:therapy; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention; D011379:Prognosis
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone
keywords: CRTD; ICD; interventions; ventricular arrhythmia