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Cigarette smoking and the risk of supraventricular and ventricular tachyarrhythmias in high-risk cardiac patients with implantable cardioverter defibrillators.

Publication ,  Journal Article
Goldenberg, I; Moss, AJ; McNitt, S; Zareba, W; Daubert, JP; Hall, WJ; Andrews, ML ...
Published in: J Cardiovasc Electrophysiol
September 2006

INTRODUCTION: Nicotine elevates serum catecholamine concentration and is therefore potentially arrhythmogenic. However, the effect of cigarette smoking on arrhythmic risk in coronary heart disease patients is not well established. METHODS AND RESULTS: The risk of appropriate and inappropriate defibrillator therapy by smoking status was analyzed in 717 patients who received an implantable cardioverter defibrillator (ICD) in the Multicenter Automatic Defibrillator Implantation Trial-II. Compared with patients who had quit smoking before study entry (past smokers) and patients who had never smoked (never smokers), patients who continued smoking (current smokers) were significantly younger and generally had more favorable baseline clinical characteristics. Despite this, the adjusted hazard ratio (HR) for appropriate ICD therapy for fast ventricular tachycardia (at heart rates >or=180 b.p.m) or ventricular fibrillation was highest among current smokers (HR = 2.11 [95% CI 1.11-3.99]) and intermediate among past smokers (HR = 1.57 [95% CI 0.95-2.58]), as compared with never smokers (P for trend = 0.02). Current smokers also exhibited a higher risk of inappropriate ICD shocks (HR = 2.93 [95% CI 1.30-6.63]) than past (HR = 1.91 [95% CI 0.97-3.77]) and never smokers (P for trend = 0.008). CONCLUSIONS: In patients with ischemic left ventricular dysfunction, continued cigarette smoking is associated with a significant increase in the risk of life-threatening ventricular tachyarrhythmias and inappropriate ICD shocks induced by rapid supraventricular arrhythmias. Our findings stress the importance of complete smoking cessation in this high-risk population.

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Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

September 2006

Volume

17

Issue

9

Start / End Page

931 / 936

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Tachycardia, Ventricular
  • Smoking Cessation
  • Smoking
  • Risk Factors
  • Prospective Studies
  • Male
  • Humans
  • Follow-Up Studies
  • Female
 

Citation

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Goldenberg, I., Moss, A. J., McNitt, S., Zareba, W., Daubert, J. P., Hall, W. J., … Multicenter Automatic Defibrillator Implantation Trial-II Investigators, . (2006). Cigarette smoking and the risk of supraventricular and ventricular tachyarrhythmias in high-risk cardiac patients with implantable cardioverter defibrillators. J Cardiovasc Electrophysiol, 17(9), 931–936. https://doi.org/10.1111/j.1540-8167.2006.00526.x
Goldenberg, Ilan, Arthur J. Moss, Scott McNitt, Wojciech Zareba, James P. Daubert, W Jackson Hall, Mark L. Andrews, and Mark L. Multicenter Automatic Defibrillator Implantation Trial-II Investigators. “Cigarette smoking and the risk of supraventricular and ventricular tachyarrhythmias in high-risk cardiac patients with implantable cardioverter defibrillators.J Cardiovasc Electrophysiol 17, no. 9 (September 2006): 931–36. https://doi.org/10.1111/j.1540-8167.2006.00526.x.
Goldenberg I, Moss AJ, McNitt S, Zareba W, Daubert JP, Hall WJ, et al. Cigarette smoking and the risk of supraventricular and ventricular tachyarrhythmias in high-risk cardiac patients with implantable cardioverter defibrillators. J Cardiovasc Electrophysiol. 2006 Sep;17(9):931–6.
Goldenberg, Ilan, et al. “Cigarette smoking and the risk of supraventricular and ventricular tachyarrhythmias in high-risk cardiac patients with implantable cardioverter defibrillators.J Cardiovasc Electrophysiol, vol. 17, no. 9, Sept. 2006, pp. 931–36. Pubmed, doi:10.1111/j.1540-8167.2006.00526.x.
Goldenberg I, Moss AJ, McNitt S, Zareba W, Daubert JP, Hall WJ, Andrews ML, Multicenter Automatic Defibrillator Implantation Trial-II Investigators. Cigarette smoking and the risk of supraventricular and ventricular tachyarrhythmias in high-risk cardiac patients with implantable cardioverter defibrillators. J Cardiovasc Electrophysiol. 2006 Sep;17(9):931–936.
Journal cover image

Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

September 2006

Volume

17

Issue

9

Start / End Page

931 / 936

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Tachycardia, Ventricular
  • Smoking Cessation
  • Smoking
  • Risk Factors
  • Prospective Studies
  • Male
  • Humans
  • Follow-Up Studies
  • Female