J Korean Med Sci.  2012 Jun;27(6):619-624. 10.3346/jkms.2012.27.6.619.

Predictors and Clinical Impact of Inappropriate Implantable Cardioverter-Defibrillator Shocks in Korean Patients

• Yang JH
• Byeon K
• Yim HR
• Park JW
• Park SJ
• Huh J
• Kim JS
• On YK

• KMID: 1421613
• DOI: http://doi.org/10.3346/jkms.2012.27.6.619

Abstract

Limited data are available on inappropriate shocks in Korean patients implanted with an implantable cardioverter-defibrillator (ICD). We investigated the impact of inappropriate shocks on clinical outcomes. This retrospective, single-center study included 148 patients treated between October 1999 and June 2011. The primary outcome was a composite event of all-cause mortality or hospitalization for any cardiac reason. The median follow-up duration was 29 months (interquartile range: 8 to 53). One or more inappropriate shocks occurred in 34 (23.0%) patients. A history of atrial fibrillation was the only independent predictor of inappropriate shock (hazard ratio [HR]: 4.16, 95% confidence interval [CI]: 1.89-9.15, P < 0.001). Atrial fibrillation was the most common cause of inappropriate shock (67.7%), followed by supraventricular tachycardia (23.5%), and abnormal sensing (8.8%). A composite event of all-cause mortality or hospitalizations for any cardiac reason during follow-up was not significantly different between patients with or without inappropriate shock (inappropriate shock vs no inappropriate shock: 35.3% vs 35.4%, adjusted HR: 1.06, 95% CI: 0.49-2.29, P = 0.877). Inappropriate shocks do not affect clinical outcomes in patients implanted with an ICD, although the incidence of inappropriate shocks is high.

Keyword

Implantable Cardioverter-Defibrillator; Inappropriate Shock

MeSH Terms

Adult
Aged
Atrial Fibrillation/complications
Defibrillators, Implantable/*adverse effects
Equipment Failure
Female
Hospitalization
Humans
Kaplan-Meier Estimate
Male
Middle Aged
*Predictive Value of Tests
Republic of Korea
Retrospective Studies
Risk Factors
Shock/*etiology/mortality
Tachycardia, Supraventricular/complications

Figure

• 

  Fig. 1 Kaplan-Meier curves of inappropriate shock versus no inappropriate shock. (A) All-cause mortality in inappropriate shock (solid) versus no inappropriate shock (dashed). (B) A composite event of all-cause mortality or hospitalization for any cardiac reason in inappropriate shock versus no inappropriate shock. (C) All-cause mortality in inappropriate shock versus no inappropriate shock in patients for second prevention of sudden cardiac death. (D) A composite event of all-cause mortality or hospitalization for any cardiac reason in inappropriate shock versus no inappropriate shock in patients for second prevention of sudden cardiac death.

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