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Inappropriate shock

Madhab Lamichhane, Joseph C Gardiner, Nicole R Bianco, Steven J Szymkiewicz, Ranjan K Thakur
PURPOSE: The wearable cardioverter defibrillator (WCD) is generally used for short periods of sudden cardiac death (SCD) risk; circumstances may occasionally result in prolonged use (over 1 year). The aim of this study was to determine the benefits and risks of prolonged use in patients with systolic heart failure (HF). METHODS: ZOLL's post-market US database included adult patients (≥18 years) with ischemic and/or non-ischemic cardiomyopathy (ICM, NICM) and at least 1 year of use...
October 17, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Nisha Bansal, Adam Szpiro, Frederick Masoudi, Robert T Greenlee, David H Smith, David J Magid, Jerry H Gurwitz, Kristi Reynolds, Grace H Tabada, Sue Hee Sung, Ashveena Dighe, Andrea Cassidy-Bushrow, Romel Garcia-Montilla, Stephen Hammill, John Hayes, Alan Kadish, Param Sharma, Paul Varosy, Humberto Vidaillet, Alan S Go
OBJECTIVE: Patients with chronic kidney disease (CKD) have higher risk of sudden cardiac death; however, they may not receive implantable cardioverter defibrillators (ICDs), in part due to higher risk of complications. We evaluated whether CKD is associated with greater risk of device-delivered shocks/antitachycardia pacing (ATP) therapies among patients receiving a primary prevention ICD. METHODS: We studied participants in the observational Cardiovascular Research Network Longitudinal Study of Implantable Cardioverter Defibrillators...
October 14, 2016: Heart: Official Journal of the British Cardiac Society
Claudia Schaarschmidt, Christof Kolb
The subcutaneous implantable defibrillator (S-ICD) has become an established tool for the prevention of sudden cardiac death. Based on its detection properties, the S‑ICD is essentially dependent on correct morphology discrimination of the QRS complex and avoidance of potential T‑wave sensing. We report on a patient who experienced multiple inappropriate S‑ICD shocks due to T‑wave oversensing in the setting of new onset of right bundle branch block. Strategies for the optimisation of the device programming are discussed...
October 13, 2016: Herzschrittmachertherapie & Elektrophysiologie
Jason Huang, Kristen K Patton, Jordan M Prutkin
BACKGROUND: The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a novel implanted defibrillator for the prevention of sudden cardiac death that avoids intravascular access. Use of this device is limited by its inability to provide backup pacing. Combined use of the S-ICD with a permanent pacemaker may be the optimal choice in certain situations though experience with the use of both devices together remains limited. METHODS: We reviewed our single center experience with the S-ICD from March 2011 to November 2015...
October 13, 2016: Pacing and Clinical Electrophysiology: PACE
Avishag Laish-Farkash, Sharon Bruoha, Amos Katz, Ilan Goldenberg, Mahmoud Suleiman, Yoav Michowitz, Nir Shlomo, Michal Einhorn-Cohen, Vladimir Khalameizer
AIMS: Cardiac resynchronization therapy (CRT) with a defibrillator (CRT-D) has downsides of high cost and inappropriate shocks compared to CRT without a defibrillator (CRT-P). Recent data suggest that the survival benefit of implantable cardioverter defibrillator (ICD) therapy is attenuated in the older age group. We hypothesized that, among octogenarians eligible for cardiac resynchronization therapy, CRT-P confers similar morbidity and mortality benefits as CRT-D. METHODS AND RESULTS: We compared morbidity and mortality outcomes between consecutive octogenarian patients eligible for CRT therapy who underwent CRT-P implantation at Barzilai MC (n = 142) vs...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Benjamin Derman, Milli Jain, Elizabeth McAninch, Casey Gashti
A 59-year-old man presented with polyuria and polydipsia immediately following his sixth cycle of rituximab and bendamustine for chronic lymphocytic leukemia. He initially compensated by increasing his oral fluid intake at home, but later developed septic shock and was admitted with orders to be kept nil per os (NPO). This prompted an episode of acute hypernatremia during which he exhibited continued polyuria with inappropriately dilute urine. Desmopressin challenge yielded no response in the urine osmolality, indicating a nephrogenic source of his diabetes insipidus (DI)...
October 10, 2016: Clinical Nephrology
Belén Gutiérrez-Gutiérrez, Elena Salamanca, Marina de Cueto, Po-Ren Hsueh, Pierluigi Viale, José Ramón Paño-Pardo, Mario Venditti, Mario Tumbarello, George Daikos, Vicente Pintado, Yohei Doi, Felipe Francisco Tuon, Ilias Karaiskos, Isabel Machuca, Mitchell J Schwaber, Özlem Kurt Azap, Maria Souli, Emmanuel Roilides, Spyros Pournaras, Murat Akova, Federico Pérez, Joaquín Bermejo, Antonio Oliver, Manel Almela, Warren Lowman, Benito Almirante, Robert A Bonomo, Yehuda Carmeli, David L Paterson, Alvaro Pascual, Jesús Rodríguez-Baño
OBJECTIVE: To develop a score to predict mortality in patients with bloodstream infections (BSIs) due to carbapenemase-producing Enterobacteriaceae (CPE). PATIENTS AND METHODS: A multinational retrospective cohort study (INCREMENT project) was performed from January 1, 2004, through December 31, 2013. Patients with clinically relevant monomicrobial BSIs due to CPE were included and randomly assigned to either a derivation cohort (DC) or a validation cohort (VC)...
October 2016: Mayo Clinic Proceedings
Shambhunath Bose, Jungsook Cho
Protein misfolding, which is known to cause several serious diseases, is an emerging field that addresses multiple therapeutic areas. Misfolding of a disease-specific protein in the central nervous system ultimately results in the formation of toxic aggregates that may accumulate in the brain, leading to neuronal cell death and dysfunction, and associated clinical manifestations. A large number of neurodegenerative diseases in humans, including Alzheimer's, Parkinson's, Huntington's, and prion diseases, are primarily caused by protein misfolding and aggregation...
October 1, 2016: Ageing Research Reviews
Christine M Tompkins, Scott McNitt, Bronislava Polonsky, James P Daubert, Paul J Wang, Arthur J Moss, Wojciech Zareba, Valentina Kutyifa
INTRODUCTION: Approximately 10-20% of ICD recipients receive inappropriate device therapies. The purpose of this study was to compare the frequency of inappropriate therapies (IT) between men and women enrolled in MADIT II and MADIT-CRT, and assess for potential adverse outcomes. METHODS: The electrograms for each ICD or CRT-D therapy, defined as either ATP or shock, were reviewed by adjudication committees for both studies. ICD therapy was considered inappropriate if it was delivered for reasons other than VT/VF...
October 2, 2016: Journal of Cardiovascular Electrophysiology
D O Verschure, B L F van Eck-Smit, G A Somsen, R J J Knol, H J Verberne
Heart failure is a life-threatening disease with a growing incidence in the Netherlands. This growing incidence is related to increased life expectancy, improvement of survival after myocardial infarction and better treatment options for heart failure. As a consequence, the costs related to heart failure care will increase. Despite huge improvements in treatment, the prognosis remains unfavourable with high one-year mortality rates. The introduction of implantable devices such as implantable cardioverter defibrillators (ICD) and cardiac resynchronisation therapy (CRT) has improved the overall survival of patients with chronic heart failure...
September 27, 2016: Netherlands Heart Journal
Marc-Alexander Ohlow, Marcus Roos, Bernward Lauer, J Christoph Geller
The purpose of this study was to assess (1) the incidence of safety margin testing <10 J (SMT) and (2) the efficacy/safety of routinely adding a subcutaneous array (SQA) (Medtronic 6996SQ) for these patients. Patients with SMT smaller than a 10-J safety margin from maximum output were considered to have very high readings and underwent SQA insertion. These patients were compared with the rest of the patients who had acceptable SMT (≥10 J). A total of 616 patients underwent ICD implantation during the analysis period...
March 2016: Indian Pacing and Electrophysiology Journal
Jeremy P Moore, Blandine Mondésert, Michael S Lloyd, Stephen C Cook, Ali N Zaidi, Robert H Pass, Anitha S John, Frank A Fish, Kevin M Shannon, Jamil A Aboulhosn, Paul Khairy
BACKGROUND: Sudden cardiac death is a major contributor to mortality for adults with congenital heart disease. The subcutaneous implantable cardioverter-defibrillator (ICD) has emerged as a novel tool for prevention of sudden cardiac death, but clinical performance data for adults with congenital heart disease are limited. METHODS AND RESULTS: A retrospective study involving 7 centers over a 5-year period beginning in 2011 was performed. Twenty-one patients (median 33...
September 2016: Circulation. Arrhythmia and Electrophysiology
Javier Jiménez-Candil, Jesús Hernández, Pedro Perdiguero, Ana Martín, José Moríñigo, Loreto Bravo, Olga Durán, Pedro Luis Sánchez
Nonsustained ventricular tachycardias (NSVTs) are frequently observed in patients with left ventricular (LV) dysfunction. The prognostic implications of such NSVTs are conflicting. Our objective was to determine the relation between the burden of NSVT occurring early (within the first 6 months after ICD implant) and prognosis among ICD patients with LV dysfunction. We followed 416 ICD patients (age: 65 ± 11 years; LV ejection fraction: 30 ± 8; ischemic origin: 62%; primary prevention: 63%) with LV dysfunction for 41 ± 27 months...
August 23, 2016: American Journal of Cardiology
Mark L Brown, Charles D Swerdlow
Ensuring sensing and detection of ventricular tachycardia (VT) and ventricular fibrillation (VF) was a prerequisite for the clinical trials that established the survival benefit of implantable cardioverter defibrillators (ICDs). However, for decades, a high incidence of unnecessary shocks limited patients' and physicians' acceptance of ICD therapy. Oversensing, misclassification of supraventricular tachycardia (SVT) as VT, and self-terminating VT accounted for the vast majority of unnecessary shocks. Medtronic ICDs utilize sensitive baseline settings with minimal blanking periods to ensure accurate sensing of VF, VT, and SVT electrograms...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
Carsten W Israel, Tatsiana Burmistrava
Optimal implantable cardioverter-defibrillator (ICD) programming can reduce the incidence of inappropriate shock therapy and improve prognosis in patients with an ICD. Only after results from randomized trials became available was the "safety first" feeling overcome that mandated early shock therapy, waived the use of antitachycardia pacing and forced shock therapy after a time of 30 s expired, even if tachycardia discriminators would have withheld the therapy. The strong evidence to limit ICD therapy to longer ventricular tachycardia (VT) should not result in individually dangerous ICD programming, particularly in patients with a high risk of slow VT (known monomorphic VT, post VT ablation, during treatment with amiodarone, very dilated left ventricle)...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
Hayrettin Hakan Aykan, Tevfik Karagoz, Mustafa Gulgun, Ilker Ertugrul, Ebru Aypar, Sema Ozer, Dursun Alehan, Alpay Celiker, Suheyla Ozkutlu
BACKGROUND: Despite concerns about complications with the implantable cardioverter-defibrillator (ICD), but it is effective for the prevention of sudden cardiac death. We aimed to analyze our mid-term experience with ICD in children and young adults. METHODS: This retrospective study included patients who were implanted with an ICD between 2001 and 2014. Demographic characteristics, clinical information, shock features and complications for all patients with ICD were analyzed...
September 13, 2016: Pacing and Clinical Electrophysiology: PACE
David Conen, Barbora Arendacká, Christian Röver, Leonard Bergau, Pascal Munoz, Sofieke Wijers, Christian Sticherling, Markus Zabel, Tim Friede
BACKGROUND: Some but not all prior studies have shown that women receiving a primary prophylactic implantable cardioverter defibrillator (ICD) have a lower risk of death and appropriate shocks than men. PURPOSE: To evaluate the effect of gender on the risk of appropriate shock, all-cause mortality and inappropriate shock in contemporary studies of patients receiving a primary prophylactic ICD. DATA SOURCE: PubMed, LIVIVO, Cochrane CENTRAL between 2010 and 2016...
2016: PloS One
Jaber Abboud, Joachim R Ehrlich
Implantable cardioverter defibrillators (ICDs) are effective in the prevention of arrhythmic sudden cardiac death. Many patients receiving an ICD are affected by heart failure and are at risk of ventricular arrhythmias, which may lead to appropriate shocks. On the other hand, in this population the incidence of atrial fibrillation, giving rise to inappropriate ICD shocks, is high. Accordingly, ICD discharges occur frequently and many patients with an ICD will need concomitant antiarrhythmic drug therapy to avoid or reduce the frequency of shocks...
August 2016: Arrhythmia & Electrophysiology Review
Jan Zdarek, Carsten W Israel
Modern implantable cardioverter/defibrillator (ICD) systems offer a multitude of algorithms to optimize performance in sensing and tachycardia detection even in difficult circumstances (e. g., ventricular tachycardia during supraventricular tachycardia, fine ventricular fibrillation with intermittent undersensing), to reliably discriminate sustained ventricular tachyarrhythmia from noise, nonsustained and supraventricular tachyarrhythmia, and to limit shock therapy only to those arrhythmias that definitely need to be treated by a shock...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
M-C-B Suran, A-D Margulescu, C Siliste, D Vinereanu
No abstract text is available yet for this article.
June 2016: Acta Cardiologica
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