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PubMed2003

[Cardiac Pacemakers, implantable defibrillators and IRM].

The IRM is formally contraindicated to the pacemaker and cardiac defibrillator wearers because of the risk of inhibition or inappropriate stimulations during the examination. However if the examination is essential, suitable programming of the apparatus and a constant monitoring of the heartbeat rate by a qualified doctor in cardiac stimulation must make it possible to avoid any accident.

Defibrillators, Implantable↗
PubMed2005

Treatment of arrhythmic storm in implantable defibrillator patients.

BACKGROUND: A common ICD therapy-related complication is arrhythmic storm (AS). The objective of our study was to define the impact of AS on patients' prognoses in order to compare the total mortality of AS patients with the rest of the group. MATERIAL/METHODS: We studied 138 patients who received ICDs between 1994 and 2001. Patients who experienced one or more arrhythmic storms were statistically compared with patients who had no accumulation of malignant arrhythmia or no episodes. RESULTS: One thousand four hundred ninety episodes of arrhythmia were analyzed. Arrhythmia recurrence was present in 71% of the patients. The majority of episodes (78%) were ventricular tachycardias and only 3% of episodes were ventricular fibrillation. Seventy percent of all arrhythmic episodes were asymptomatic. The ICD therapy sensitivity was 99.7%. Thirty-eight arrhythmic storms in 19 patients (14%) were observed during follow-up. The occurrence of AS was twice as high among patients with LVEF <35% than the rest of the group (18% vs. 8%). The total survival of patients with AS was significantly lower than that of the ICD patients who did not experience an AS (36.8% vs. 16.8%, p=0.042). All episodes of arrhythmic clusters during the AS were ventricular tachycardias. CONCLUSIONS: Arrhythmic storm is a serious risk marker for cardiac death. Ventricular tachycardia is a basic rhythm disorder of AS episodes and occurs significantly more often than ventricular fibrillation. Arrhythmic storm is responsible for a 4.6 times more frequent re-admission to hospital.

Aged↗
PubMed2005

Implantable defibrillators with and without resynchronization for patients with left ventricular dysfunction.

In conclusion, sudden cardiac arrest is a major cause of mortality in patients with LV dysfunction, even in asymptomatic patients. Low EF and heart failure may contribute synergistically to this risk, and may confer a risk of sudden death that accumulates over time. Several studies confirm that ICDs are more effective than optimal medical therapy at reducing SCA, although efforts must focus on optimizing medical therapy. Finally, ventricular dyssynchrony is a major risk factor for cardiac mortality that is best ameliorated by CRT. Future studies using markers of mechanical dyssynchrony will likely enhance the ability of CRT to reduce symptoms, hospitalization, and mortality.

Death, Sudden, Cardiac↗