Background: Implantable cardioverter defibrillator (ICD) is an effective treatment for secondary prevention of ventricular\ntachycardia/ventricular fibrillation (VT/VF). Left ventricular (LV) remodeling may develop before ICD implant and over time.\nHowever, it remains unclear how LV remodeling affects subsequent risk for recurrence VT/VF in ICD recipients under\noptimal medical therapy.\nMethods: From May of 2004 to June of 2015, 144 patients received ICD implantation for secondary prevention were\nenrolled in this study. All information interrogated from ICD devices during follow-up or ICD therapy history (antitachycardia\npacing and shock therapy) were reviewed and validated the occurrences of VT/VF.\nResults: At a mean follow-up of 1110.5 �± 860.6 days, 53 patients (36.8%) had recurrence of VT/VF episodes and 91\npatients had no recurrence of VT/VF episode after ICD implant. Left ventricular end-diastolic volume (LVEDV) > 163.5 mL\nhad significant predictive value for VT/VF recurrence (area under the curve: 0.602, p = 0.041). Moreover, the percentage of\npatients with LVEDV >163.5 mL was significantly higher in patients with recurrent VT/VF than patients without recurrent\nVT/VF (62.3 vs 40.0%, p = 0.010). Left ventricular ejection fraction â�¤ 30% (p = 0.031), LVEDV > 163.5 mL (p = 0.012) and QRS\nwidth > 125 msec (p = 0.049) were significant predictors for VT/VF recurrence by univariate Cox regression analysis.\nHowever, only LVEDV > 163.5 mL (hazard ratio: 2.549, 95% confidence interval: 1.249 ~ 5.201, p = 0.010) and QRS width\n> 125 msec (hazard ratio: 2.173, 95% confidence interval: 1.030 ~ 4.586, p = 0.042) were independent predictors for\nrecurrence of VT/VF after multivariable adjustment.\nConclusion: LV remodeling and QRS width > 125 msec were independent predictors for VT/VF recurrence in secondary\nprevention ICD recipients under optimal medical therapy, independent of LV ejection fraction.
Loading....