Journal: Pacing and clinical electrophysiology : PACE
Article Title: Effect of Significant Weight Change on Inappropriate Implantable Cardioverter-Defibrillator Therapy.
PMID/MRN: 27808410
Publication Date: 2016-Nov-03
Abstract:
Weight loss has been associated with adverse outcomes among heart failure (HF) patients, including those receiving cardiac resynchronization therapy with defibrillator (CRT-D). The effect of significant weight change on inappropriate implantable cardioverter-defibrillator (ICD) therapy among CRT-D patients is not well understood.
We evaluated the impact of significant weight change at 1 year on subsequent inappropriate ICD therapy during follow-up among 993 CRT-D patients enrolled in MADIT-CRT. Patients were divided into 3 sub-groups based on weight change at 1 year after enrollment: weight loss (weight loss ³ 5%), weight gain (weight gain ³ 5%), and stable weight (weight loss and weight gain < 5%). The primary end point was inappropriate ICD therapy. Secondary end point included inappropriate ICD therapy related to supraventricular arrhythmias (SVAs).
There were 102 (10.3%) patients who experienced weight loss, 689 (69.4%) whose weight was stable, and 202 (20.3%) who gained weight at 1 year. Patients with weight loss had increased risk of subsequent inappropriate ICD therapy relative to patients with stable weight (HR = 2.35, 95% CI: 1.39-3.98, p = 0.001) or weight gain (HR = 2.27, 95% CI: 1.18-4.38, p = 0.014). Furthermore, patients losing weight were at greater risk of subsequent inappropriate ICD therapy related to SVAs when compared to patients with stable weight (HR = 2.16, 95% CI: 1.18-3.95, p = 0.013) or weight gain (HR = 2.02, 95% CI: 0.95-4.29, p = 0.068).
In mild HF patients receiving CRT-D, significant weight loss at 1 year is associated with increased risk of subsequent inappropriate ICD therapy, including risk related to SVAs. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.