TY - JOUR
T1 - Left ventricular ejection fraction as criterion for implantation of an implantable cardioverter-defibrillator in heart failure patients undergoing surgical left ventricular reconstruction
AU - Mollema, Sjoerd A.
AU - Klein, Patrick
AU - Heersche, Jogien
AU - Schalij, Martin J.
AU - van der Wall, Ernst E.
AU - Versteegh, Michel I. M.
AU - Klautz, Robert J. M.
AU - van Erven, Lieselot
AU - Bax, Jeroen J.
PY - 2009
Y1 - 2009
N2 - Background: Besides implantation of an implantable cardioverter- defibrillator (ICD), a proportion of patients with left ventricular (LV) dysfunction due to ischemic cardiomyopathy are potential candidates for surgical LV reconstruction (Dor procedure), which changes LV ejection fraction (LVEF) considerably. In these patients, LVEF as selection criterium for ICD implantation may be difficult. This study aimed to determine the value of LVEF as criterium for ICD implantation in heart failure patients undergoing surgical LV reconstruction. Methods: Consecutive patients with end-stage heart failure who underwent ICD implantation and LV reconstruction were evaluated. During admission, two-dimensional (2D) echocardiography (LV volumes and LVEF) was performed before surgery and was repeated at 3 months after surgery. Over a median follow-up of 18 months, the incidence of ICD therapy was evaluated. Results: The study population consisted of 37 patients (59 ± 11 years). At baseline, mean LVEF was 23 ± 5%. Mean left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) were 175 ± 73 mL and 225 ± 88 mL, respectively. At 3-month follow-up, mean LVEF was 41 ± 9% (P < 0.0001 vs. baseline), and mean LVESV and LVEDV were 108 ± 65 mL and 176 ± 73 mL, respectively (P < 0.0001 vs. baseline). During 18-month follow-up, 12 (32%) patients had ventricular arrhythmias, resulting in appropriate ICD therapy. No significant relations existed between baseline LVEF (P = 0.77), LVEF at 3-month follow-up (P = 0.34), change in LVEF from baseline to 3-month follow-up (P = 0.28), and the occurrence of ICD therapy during 18-month follow-up. Conclusion: LVEF before and after surgical LV reconstruction is of limited use as criterium for ICD implantation in patients with end-stage heart failure. (PACE 2009; 32:913-917) © 2009 Wiley Periodicals, Inc.
AB - Background: Besides implantation of an implantable cardioverter- defibrillator (ICD), a proportion of patients with left ventricular (LV) dysfunction due to ischemic cardiomyopathy are potential candidates for surgical LV reconstruction (Dor procedure), which changes LV ejection fraction (LVEF) considerably. In these patients, LVEF as selection criterium for ICD implantation may be difficult. This study aimed to determine the value of LVEF as criterium for ICD implantation in heart failure patients undergoing surgical LV reconstruction. Methods: Consecutive patients with end-stage heart failure who underwent ICD implantation and LV reconstruction were evaluated. During admission, two-dimensional (2D) echocardiography (LV volumes and LVEF) was performed before surgery and was repeated at 3 months after surgery. Over a median follow-up of 18 months, the incidence of ICD therapy was evaluated. Results: The study population consisted of 37 patients (59 ± 11 years). At baseline, mean LVEF was 23 ± 5%. Mean left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) were 175 ± 73 mL and 225 ± 88 mL, respectively. At 3-month follow-up, mean LVEF was 41 ± 9% (P < 0.0001 vs. baseline), and mean LVESV and LVEDV were 108 ± 65 mL and 176 ± 73 mL, respectively (P < 0.0001 vs. baseline). During 18-month follow-up, 12 (32%) patients had ventricular arrhythmias, resulting in appropriate ICD therapy. No significant relations existed between baseline LVEF (P = 0.77), LVEF at 3-month follow-up (P = 0.34), change in LVEF from baseline to 3-month follow-up (P = 0.28), and the occurrence of ICD therapy during 18-month follow-up. Conclusion: LVEF before and after surgical LV reconstruction is of limited use as criterium for ICD implantation in patients with end-stage heart failure. (PACE 2009; 32:913-917) © 2009 Wiley Periodicals, Inc.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=67650687067&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/19572868
U2 - https://doi.org/10.1111/j.1540-8159.2009.02408.x
DO - https://doi.org/10.1111/j.1540-8159.2009.02408.x
M3 - Article
C2 - 19572868
SN - 0147-8389
VL - 32
SP - 913
EP - 917
JO - Pacing and clinical electrophysiology
JF - Pacing and clinical electrophysiology
IS - 7
ER -