Arrhythmic risk following recovery of left ventricular ejection fraction in patients with primary prevention ICD

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dc.contributor.authorBerthelot Richer, Maxime-
dc.contributor.authorBonenfant, Francis-
dc.contributor.authorClavel, Marie-Annick-
dc.contributor.authorFarand, Paul-
dc.contributor.authorPhilippon, François-
dc.contributor.authorAyala-Parades, Félix-
dc.contributor.authorEssadiqi, Btissama-
dc.contributor.authorBadra-Verdu, Mariano Gonzalo-
dc.contributor.authorRoux, Jean-François-
dc.description.abstractBackground: Left ventricular ejection fraction (LVEF) recovers during follow-up in a significant proportion of patients implanted with a cardioverter defibrillator (ICD) for primary prevention. Little is known about the midterm arrhythmic risk in this population, particularly in relation to the presence or absence of ischemic cardiomyopathy. Methods and Results: We retrospectively analyzed 286 patients with an ICD implanted for primary prevention between 2002 and 2010. Patients were divided into two groups based on their last LVEF assessment: (1) Recovery, defined as an LVEF > 35%; and (2) No-Recovery, defined as an LVEF 35%. Kaplan-Meir curves and multivariate Cox regression analysis were performed separately for patients with ischemic (211 patients) and nonischemic (75 patients) cardiomyopathy. Forty-nine patients (17.1%) had LVEF recovery to >35% at last follow-up. Overall, 72 patients (25.2%) experienced ventricular arrhythmias requiring ICD therapy during a median follow-up of 4.4 years. With multivariate Cox regression, LVEF recovery was associated with a lower arrhythmic risk in the whole cohort (hazard ratio [HR]: 0.38 [0.13– 0.85]; P = 0.02) and in the nonischemic cardiomyopathy cohort (HR: 0.10 [0.005–0.55]; P = 0.005), but not in the ischemic cardiomyopathy cohort (HR: 0.84 [0.25–2.10]; P = 0.74). Conclusion: In conclusion, patients with nonischemic cardiomyopathy who improved their LVEF to >35% after primary prevention ICD implantation were at very low absolute arrhythmic risk. Our study raises the possibility that the LVEF cutoff to safely withhold ICD replacement might be higher in patients with ischemic compared to nonischemic cardiomyopathy. This will need to be confirmed in prospective studies.fr_CA
dc.publisherNorth American Society of Pacing & Electrophysiologyfr_CA
dc.subjectArrhythmic riskfr_CA
dc.subjectImplantable cardioverter defibrillatorfr_CA
dc.subjectLeft ventricular ejection fraction recoveryfr_CA
dc.subjectNonischemic cardiomyopathyfr_CA
dc.titleArrhythmic risk following recovery of left ventricular ejection fraction in patients with primary prevention ICDfr_CA
dc.typeCOAR1_1::Texte::Périodique::Revue::Contribution à un journal::Article::Article de recherche-
dcterms.bibliographicCitationPacing and clinical electrophysiology (2016)fr_CA
dc.audienceProfesseurs (Enseignement supérieur)fr_CA
dc.subject.rvmArythmie -- Facteurs de risquefr_CA
dc.subject.rvmCœur -- Ventricule gauchefr_CA
dc.subject.rvmDéfibrillateurs implantablesfr_CA
rioxxterms.versionVersion of Recordfr_CA
Collection:Articles publiés dans des revues avec comité de lecture

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