Digitalis Therapy and Risk of Recurrent Ventricular Tachyarrhythmias and ICD Therapies in Atrial Fibrillation and Heart Failure.

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

Cardiology

journal_title

Cardiology

authors

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 I

doi

10.1159/000497271

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

129-140

issue

3

eissn

0008-6312

issn

1421-9751

pii

000497271

journal_volume

142

pub_type

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