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  • 1
    Online Resource
    Online Resource
    Impact of Different Pharmacotherapies on Long-Term Outcomes in Patients with Electrical Storm
    S. Karger AG ; 2019
    In:  Pharmacology Vol. 103, No. 3-4 ( 2019), p. 179-188
    Details
    In: Pharmacology, S. Karger AG, Vol. 103, No. 3-4 ( 2019), p. 179-188
    Abstract: 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 The study sought to assess the long-term prognostic impact of different pharmacotherapies, including angiotensin-converting enzyme inhibitor-inhibitor/angiotensin receptor blocker (ACEi/ARB), statins, and amiodarone in patients with electrical storm (ES). 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Data regarding the outcome of patients with ES is limited. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Consecutive patients with ES from 2002 to 2016 were included. Patients on ACEi/ARB were compared to patients without ACEi/ARB, respectively, for statin and amiodarone therapy. The primary prognostic endpoint was all-cause mortality at 4 years. Secondary endpoints comprised ES recurrences, rehospitalization, and major adverse cardiac events (MACE) at 4 years. Kaplan-Meier survival curves and multivariable Cox regression analyses were applied. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 84 consecutive patients surviving episodes of ES was included. Beta-blocker was given in 95%, ACEi/ARB in 80%, statin in 60%, and amiodarone in 54%. ACEi/ARB patients were associated with improved all-cause mortality at 4 years (mortality rate 34 vs. 65%, log rank 〈 i 〉 p 〈 /i 〉 = 0.018; HR 0.428; 95% CI 0.208–0.881; 〈 i 〉 p 〈 /i 〉 = 0.021), as well as improved freedom from MACE. In contrast, statin and amiodarone therapy had no impact on long-term outcomes in ES patients. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 ACEi/ARB therapy is associated with improved survival and MACE in patients with ES, whereas statins and amiodarone therapy had no impact on long-term prognostic endpoints.
    Type of Medium: Online Resource
    ISSN: 0031-7012 , 1423-0313
    URL: Article
    DOI: 10.1159/000496228
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2019
    detail.hit.zdb_id: 1483550-2
    SSG: 15,3
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  • 2
    Online Resource
    Online Resource
    Digitalis Therapy and Risk of Recurrent Ventricular Tachyarrhythmias and ICD Therapies in Atrial Fibrillation and Heart Failure
    S. Karger AG ; 2019
    In:  Cardiology Vol. 142, No. 3 ( 2019), p. 129-140
    Details
    In: Cardiology, S. Karger AG, Vol. 142, No. 3 ( 2019), p. 129-140
    Abstract: 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 This study sought to assess the impact of treatment with digitalis on recurrences of ventricular tachyarrhythmias in implantable cardioverter defibrillator (ICD) recipients with atrial fibrillation (AF) and heart failure (HF). 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The data regarding outcomes of digitalis therapy in ICD recipients are limited. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A large retrospective registry was used, including consecutive ICD recipients with episodes of ventricular tachyarrhythmia between 2002 and 2016. Patients treated with digitalis were compared to patients without digitalis treatment. The primary prognostic outcome was first recurrence of ventricular tachyarrhythmia at 5 years. Kaplan-Meier and multivariable Cox regression analyses were applied. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 394 ICD recipients with AF and/or HF was included (26% with digitalis treatment and 74% without). Digitalis treatment was associated with decreased freedom from recurrent ventricular tachy­arrhythmias (HR = 1.423; 95% CI 1.047–1.934; 〈 i 〉 p 〈 /i 〉 = 0.023). Accordingly, digitalis treatment was associated with decreased freedom from appropriate ICD therapies (HR = 1.622; 95% CI 1.166–2.256; 〈 i 〉 p 〈 /i 〉 = 0.004) and, moreover, higher rates of rehospitalization (38 vs. 21%; 〈 i 〉 p 〈 /i 〉 = 0.001) and all-cause mortality (33 vs. 20%; 〈 i 〉 p 〈 /i 〉 = 0.011). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Among ICD recipients suffering from AF and HF, treatment with digitalis was associated with increased rates of recurrent ventricular tachyarrhythmias and ICD therapies. However, the endpoints may also have been driven by interactions between digitalis, AF, and HF.
    Type of Medium: Online Resource
    ISSN: 0008-6312 , 1421-9751
    URL: Article
    DOI: 10.1159/000497271
    RVK:
    XA 36200
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2019
    detail.hit.zdb_id: 1482041-9
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  • 3
    Online Resource
    Online Resource
    Effect of Mineralocorticoid Receptor Antagonists on the Prognosis of Patients with Ventricular Tachyarrhythmias
    S. Karger AG ; 2022
    In:  Pharmacology Vol. 107, No. 1-2 ( 2022), p. 35-45
    Details
    In: Pharmacology, S. Karger AG, Vol. 107, No. 1-2 ( 2022), p. 35-45
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 The study sought to assess the effect of treatment with mineralocorticoid receptor antagonists (MRAs) on long-term prognosis of patients with systolic heart failure (HF) surviving index episodes of ventricular tachyarrhythmias. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A large retrospective registry was used including consecutive HF patients with left ventricular ejection fraction & #x3c;45% and index episodes of ventricular tachyarrhythmias from 2002 to 2015. The primary endpoint was all-cause mortality at 3 years and secondary endpoints were rehospitalization, as well as the composite endpoint consisting of recurrent ventricular tachyarrhythmias, sudden cardiac death and appropriate implantabe cardioverter defibrillator (ICD) therapies at 3 years. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 748 patients were included, 20% treated with MRA and 80% without. At 3 years, treatment with MRA was not associated with improved all-cause mortality (22% vs. 24%, log-rank 〈 i 〉 p 〈 /i 〉 = 0.968; hazard ratio (HR) = 1.008; 95% CI 0.690–1.472; 〈 i 〉 p 〈 /i 〉 = 0.968). Accordingly, risk of the composite endpoint (28% vs. 27%; HR = 1.131; 95% CI 0.806–1.589; 〈 i 〉 p 〈 /i 〉 = 0.476) and first cardiac rehospitalization (24% vs. 22%; HR = 1.139; 95% CI 0.788–1.648; 〈 i 〉 p 〈 /i 〉 = 0.489) were not affected by treatment with MRA. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 In patients with ventricular tachyarrhythmias, treatment with MRA was not associated with improved all-cause mortality at 3 years. The therapeutic effect of MRA treatment in patients with ventricular tachyarrhythmias needs to be reinvestigated within further randomized controlled trials.
    Type of Medium: Online Resource
    ISSN: 0031-7012 , 1423-0313
    URL: Article
    DOI: 10.1159/000520310
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1483550-2
    SSG: 15,3
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  • 4
    Online Resource
    Online Resource
    Prognostic Impact of Atrial Fibrillation in Electrical Storm
    S. Karger AG ; 2019
    In:  Cardiology Vol. 144, No. 1-2 ( 2019), p. 9-17
    Details
    In: Cardiology, S. Karger AG, Vol. 144, No. 1-2 ( 2019), p. 9-17
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Data regarding the prognostic impact of atrial fibrillation (AF) in patients with electrical storm (ES) is rare. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 This study sought to assess the prognostic impact of AF in patients with ES on mortality, rehospitalization, major adverse cardiovascular events (MACE) and recurrence of ES (ES-R). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 All consecutive implantable cardioverter defibrillator (ICD) patients presenting with ES were included retrospectively from 2002 to 2016. Patients with AF were compared to non-AF patients. The primary prognostic endpoint was all-cause mortality. Secondary endpoints were in-hospital mortality, rehospitalization rates, MACE and ES-R. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 87 ES patients with ICD were included and followed up to 2.5 years; 43% suffered from AF. The presence of AF was associated with increased all-cause mortality (47 vs. 29%, log-rank 〈 i 〉 p 〈 /i 〉 = 0.052; hazard ratio [HR] 1.969, 95% confidence interval [CI] 0.981–3.952, 〈 i 〉 p 〈 /i 〉 = 0.057), which was no longer present after multivariable adjustment for age, diabetes and dilated cardiomyopathy. Furthermore, AF was associated with increased rates of overall rehospitalization (61 vs. 31%, log-rank 〈 i 〉 p 〈 /i 〉 = 0.013; HR 2.381, 95% CI 1.247–4.547, 〈 i 〉 p 〈 /i 〉 = 0.009), especially due to AF (14 vs. 0%, 〈 i 〉 p 〈 /i 〉 = 0.001) and acute heart failure (AHF) (28 vs. 10%, 〈 i 〉 p 〈 /i 〉 = 0.018; HR 3.754, 95% CI 1.277–11.038, 〈 i 〉 p 〈 /i 〉 = 0.016). Notably, AF was not associated with differences in MACE (55 vs. 37%, log rank 〈 i 〉 p 〈 /i 〉 = 0.339) and ES-R (28 vs. 25%, log rank 〈 i 〉 p 〈 /i 〉 = 0.704). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 In ES patients, presence of AF was univariably associated with increased rates of all-cause mortality at 2.5 years. Furthermore, AF was multivariably associated with overall rehospitalization, especially due to AF and AHF.
    Type of Medium: Online Resource
    ISSN: 0008-6312 , 1421-9751
    URL: Article
    DOI: 10.1159/000500262
    RVK:
    XA 36200
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2019
    detail.hit.zdb_id: 1482041-9
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  • 5
    Online Resource
    Online Resource
    Impact of Left Ventricular Ejection Fraction on Recurrent Ventricular Tachyarrhythmias in Recipients of Implantable Cardioverter Defibrillators
    S. Karger AG ; 2020
    In:  Cardiology Vol. 145, No. 6 ( 2020), p. 359-369
    Details
    In: Cardiology, S. Karger AG, Vol. 145, No. 6 ( 2020), p. 359-369
    Abstract: Objective: This study evaluates the impact of left ventricular ejection fraction (LVEF) on recurrences of ventricular tachyarrhythmias in recipients of implantable cardioverter defibrillator (ICD). Background: Data regarding recurrences of ventricular tachyarrhythmias in ICD recipients according to LVEF is limited. Methods: A large retrospective registry was used, including all consecutive ICD recipients with episodes of ventricular tachycardia (VT) or fibrillation (VF) from 2002 to 2016. Patients with LVEF 〈 35% were compared to patients with LVEF ≥35%. The primary end point was first recurrences of ventricular tachyarrhythmias at 5 years. Secondary end points were ICD-related therapies, rehospitalization, and all-cause mortality at 5 years. Cox regression, Kaplan Meier, and propensity score matching analyses were applied. Results: A total of 528 consecutive ICD recipients were included (51% with LVEF ≥35% and 49% with LVEF 〈 35%). LVEF 〈 35% was associated with reduced freedom from recurrent ventricular tachyarrhythmias (40 vs. 49%, log rank p = 0.014; hazard ratio [HR] = 1.381; 95% confidence interval [CI] 1.066–1.788; p = 0.034), mainly attributed to recurrent sustained VT in primary preventive ICD recipients. Accordingly, LVEF 〈 35% was associated with reduced freedom from first appropriate ICD therapies (28 vs. 41%, log rank p = 0.001; HR = 1.810; 95% CI 1.185–2.766; p = 0.001). Finally, LVEF 〈 35% was associated with a higher rate of rehospitalization (23 vs. 34%; p = 0.005) and all-cause mortality at 5 years (13 vs. 29%; p = 0.001). Conclusion: LVEF 〈 35% was associated with reduced freedom from recurrent ventricular tachyarrhythmias, appropriate device therapies, rehospitalization and all-cause mortality secondary to index ventricular tachyarrhythmias.
    Type of Medium: Online Resource
    ISSN: 0008-6312 , 1421-9751
    URL: Article
    DOI: 10.1159/000504876
    RVK:
    XA 36200
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1482041-9
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