Abstract:
OBJECTIVE:This study sought to assess the impact of treatment with digitalis on recurrences of ventricular tachyarrhythmias in implantable cardioverter defibrillator (ICD) recipients with atrial fibrillation (AF) and heart failure (HF). BACKGROUND:The data regarding outcomes of digitalis therapy in ICD recipients are limited. METHODS:A large retrospective registry was used, including consecutive ICD recipients with episodes of ventricular tachyarrhythmia between 2002 and 2016. Patients treated with digitalis were compared to patients without digitalis treatment. The primary prognostic outcome was first recurrence of ventricular tachyarrhythmia at 5 years. Kaplan-Meier and multivariable Cox regression analyses were applied. RESULTS:A total of 394 ICD recipients with AF and/or HF was included (26% with digitalis treatment and 74% without). Digitalis treatment was associated with decreased freedom from recurrent ventricular tachy-arrhythmias (HR = 1.423; 95% CI 1.047-1.934; p = 0.023). Accordingly, digitalis treatment was associated with decreased freedom from appropriate ICD therapies (HR = 1.622; 95% CI 1.166-2.256; p = 0.004) and, moreover, higher rates of rehospitalization (38 vs. 21%; p = 0.001) and all-cause mortality (33 vs. 20%; p = 0.011). CONCLUSION:Among ICD recipients suffering from AF and HF, treatment with digitalis was associated with increased rates of recurrent ventricular tachyarrhythmias and ICD therapies. However, the endpoints may also have been driven by interactions between digitalis, AF, and HF.
journal_name
Cardiologyjournal_title
Cardiologyauthors
Schupp T,Behnes M,Weiss C,Nienaber C,Reiser L,Bollow A,Taton G,Reichelt T,Ellguth D,Engelke N,Rusnak J,Weidner K,Akin M,Mashayekhi K,Borggrefe M,Akin Idoi
10.1159/000497271subject
Has Abstractpub_date
2019-01-01 00:00:00pages
129-140issue
3eissn
0008-6312issn
1421-9751pii
000497271journal_volume
142pub_type
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