Defibrillation testing and clinical outcomes after implantable cardioverter-defibrillator implantation in patients in atrial fibrillation at the time of implant: An analysis from the SIMPLE trial

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F19%3A00077653" target="_blank" >RIV/00023001:_____/19:00077653 - isvavai.cz</a>

Result on the web

<a href="https://reader.elsevier.com/reader/sd/pii/S1547527118307227?token=7D7E2DFEBE3977B45033A92D3252832CB19F5963B29F3A3E70AC1F5770B3DB9B51577B6320D3EFE24E1D3269F449341A" target="_blank" >https://reader.elsevier.com/reader/sd/pii/S1547527118307227?token=7D7E2DFEBE3977B45033A92D3252832CB19F5963B29F3A3E70AC1F5770B3DB9B51577B6320D3EFE24E1D3269F449341A</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.hrthm.2018.07.030" target="_blank" >10.1016/j.hrthm.2018.07.030</a>

Result language

angličtina

Original language name

Defibrillation testing and clinical outcomes after implantable cardioverter-defibrillator implantation in patients in atrial fibrillation at the time of implant: An analysis from the SIMPLE trial

Original language description

BACKGROUND The Shockless IMPLant Evaluation (SIMPLE) trial showed that defibrillation testing (DT) at the time of implantable cardioverter-defibrillator (ICD) implant did not improve shock efficacy or reduce mortality. There are no data regarding the risk of complications, including stroke, among patients with atrial fibrillation (AF) who undergo DT. OBJECTIVE The purpose of this prospectively planned substudy of SIMPLE was to evaluate the effect of DT vs no DT on clinical outcomes among patients with AF. METHODS We compared efficacy (failed appropriate shock/arrhythmic death) and safety between patients who had AF on their immediate preprocedural ECG to the rest of the study patients. Then among patients with AF we compared these outcomes between patients randomized to DT vs no DT. RESULTS Of the 2500 patients enrolled in SIMPLE, 251 (10%) were in AF immediately before ICD implant. AF patients had an increased risk of failed appropriate shock/arrhythmic death adjusted hazard ratio [HR] 1.64; 95% confidence interval [CI] 1.13-2.39; P = .009) and higher all-cause mortality (adjusted HR 1.58; 95% CI 1.2-2.08; P = .001). Among AF patients, perioperative complications and stroke did not significantly differ between DT vs no-DT groups (9.2% vs 5.4 0 /0; P = .2; and 1.7% vs 1.5%; P &gt;.999, respectively). Failed appropriate shock or arrhythmic death occurred in 35 of 251 AF patients (14%), and the no-DT group proved not inferior to the DT group (HR 0.58; 95 0 /0 CI 0.30-1.15; P-noninferiority = .006). CONCLUSION ICD recipients with AF are at increased risk for adverse outcomes; however, DT does not improve arrhythmic survival or shock efficacy. There is no evidence that DT increased the occurrence of perioperative stroke.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2019

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Heart rhythm

ISSN

1547-5271

e-ISSN

—

Volume of the periodical

16

Issue of the periodical within the volume

1

Country of publishing house

US - UNITED STATES

Number of pages

8

Pages from-to

83-90

UT code for WoS article

000454718800022

EID of the result in the Scopus database

2-s2.0-85058623338