Incidence of ventricular arrhythmic events in CKD patients with ICD

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• 作者：Má ; rcio Galindo Kiuchi ; MD ; PhD^a ; ^c ; ^{marciokiuchi@gmail.com} ; Shaojie Chen ; MD ; PhD^b ; ^c ; Helmut Pü ; rerfellner ; MD ; PhD^c (Prof.)
• 关键词：Ventricular dysfunction ; Anti-tachycardia Therapy Pacing ; Automatic cardioverter defibrillator ; Shock therapy ; Ventricular arrhythmias ; Chronic renal disease
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：15 January 2017
• 年：2017
• 卷：227
• 期：Complete
• 页码：312-317
• 全文大小：345 K
• 卷排序：227

文摘

This study examined patients with chronic kidney disease (CKD) in stages 1, 2, 3 and 4, left ventricular dysfunction and automatic implantable cardioverter-defibrillator (ICD). Our goal was to record the appropriate therapies, “Anti-tachycardia Therapy Pacing” (ATP) and shock events during the 12 months of follow-up and compare the incidence and severity of these at different stages of CKD.MethodsSeventy-six patients were evaluated once every three months till one year of follow-up. The arrhythmic events were assessed at each follow-up visit.ResultsComparing the groups, patients with CKD stage 4 had a higher number of ATP (45.1 ± 4.4) and shock (33.3 ± 5.0) events compared to other groups (P < 0.0001 for both comparisons in relation to other groups). Along the 12 months, 69% received ATP and 63% were treated with shock, P < 0.0001 by Log-rank/Mantel-Haenszel test compared to the other groups. Regarding the ATP events, patients with CKD stage 4 showed the hazard ratio (HR) of 11.800, with a confidence interval of 95% (CI 95%) from 3.673 to 37,930, P < 0.0001 vs. patients with CKD stage 1; HR of 7.957, with a CI 95% from 2.578 to 24.570, P < 0.0001 vs. patients with CKD stage 2; and HR of 2.902, with a CI 95% 1.054–7.986, P = 0.0391 vs. patients with CKD stage 3. In relation to the shock events, patients with CKD stage 4 showed the HR of 20,010, with a CI 95% from 5.262 to 76.080, P < 0.0001 vs. patients with CKD stage 1; HR of 10.060 with a CI 95% 3.026–33.450, P = 0.0001 vs. patients with CKD stage 2; and HR of 2.880, with a CI 95% 1.029–8.060, P = 0.0323 vs. patients with CKD stage 3.ConclusionOur results suggest that the more advanced the stage of CKD higher the HR of ATP and shock events.