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Predicting appropriate shocks in patients with heart failure: Patient level meta-analysis from SCD-HeFT and MADIT II.

Publication ,  Conference
Zeitler, EP; Al-Khatib, SM; Friedman, DJ; Han, JY; Poole, JE; Bardy, GH; Bigger, JT; Buxton, AE; Moss, AJ; Lee, KL; Dorian, P; Cappato, R ...
Published in: J Cardiovasc Electrophysiol
November 2017

BACKGROUND: No precise tools exist to predict appropriate shocks in patients with a primary prevention ICD. We sought to identify characteristics predictive of appropriate shocks in patients with a primary prevention implantable cardioverter defibrillator (ICD). METHODS: Using patient-level data from the Multicenter Automatic Defibrillator Implantation Trial II (MADIT II) and the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), we identified patients with any appropriate shock. Clinical and demographic variables were included in a logistic regression model to predict appropriate shocks. RESULTS: There were 1,463 patients randomized to an ICD, and 285 (19%) had ≥1 appropriate shock over a median follow-up of 2.59 years. Compared with patients without appropriate ICD shocks, patients who received any appropriate shock tended to have more severe heart failure. In a multiple logistic regression model, predictors of appropriate shocks included NYHA class (NYHA II vs. I: OR 1.65, 95% CI 1.07-2.55; NYHA III vs. I: OR 1.74, 95% CI 1.10-2.76), lower LVEF (per 1% change) (OR 1.04, 95% CI 1.02-1.06), absence of beta-blocker therapy (OR 1.61, 95% CI 1.23-2.12), and single chamber ICD (OR 1.67, 95% CI 1.13-2.45). CONCLUSION: In this meta-analysis of patient level data from MADIT-II and SCD-HeFT, higher NYHA class, lower LVEF, no beta-blocker therapy, and single chamber ICD (vs. dual chamber) were significant predictors of appropriate shocks.

Duke Scholars

Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

November 2017

Volume

28

Issue

11

Start / End Page

1345 / 1351

Location

United States

Related Subject Headings

  • Risk Factors
  • Randomized Controlled Trials as Topic
  • Predictive Value of Tests
  • Multicenter Studies as Topic
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Female
  • Electroshock
 

Citation

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MLA
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Zeitler, E. P., Al-Khatib, S. M., Friedman, D. J., Han, J. Y., Poole, J. E., Bardy, G. H., … Sanders, G. D. (2017). Predicting appropriate shocks in patients with heart failure: Patient level meta-analysis from SCD-HeFT and MADIT II. In J Cardiovasc Electrophysiol (Vol. 28, pp. 1345–1351). United States. https://doi.org/10.1111/jce.13307
Zeitler, Emily P., Sana M. Al-Khatib, Daniel J. Friedman, Joo Yoon Han, Jeanne E. Poole, Gust H. Bardy, J Thomas Bigger, et al. “Predicting appropriate shocks in patients with heart failure: Patient level meta-analysis from SCD-HeFT and MADIT II.” In J Cardiovasc Electrophysiol, 28:1345–51, 2017. https://doi.org/10.1111/jce.13307.
Zeitler EP, Al-Khatib SM, Friedman DJ, Han JY, Poole JE, Bardy GH, et al. Predicting appropriate shocks in patients with heart failure: Patient level meta-analysis from SCD-HeFT and MADIT II. In: J Cardiovasc Electrophysiol. 2017. p. 1345–51.
Zeitler, Emily P., et al. “Predicting appropriate shocks in patients with heart failure: Patient level meta-analysis from SCD-HeFT and MADIT II.J Cardiovasc Electrophysiol, vol. 28, no. 11, 2017, pp. 1345–51. Pubmed, doi:10.1111/jce.13307.
Zeitler EP, Al-Khatib SM, Friedman DJ, Han JY, Poole JE, Bardy GH, Bigger JT, Buxton AE, Moss AJ, Lee KL, Dorian P, Cappato R, Kadish AH, Kudenchuk PJ, Mark DB, Inoue LYT, Sanders GD. Predicting appropriate shocks in patients with heart failure: Patient level meta-analysis from SCD-HeFT and MADIT II. J Cardiovasc Electrophysiol. 2017. p. 1345–1351.
Journal cover image

Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

November 2017

Volume

28

Issue

11

Start / End Page

1345 / 1351

Location

United States

Related Subject Headings

  • Risk Factors
  • Randomized Controlled Trials as Topic
  • Predictive Value of Tests
  • Multicenter Studies as Topic
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Female
  • Electroshock