A history of heart failure predicts arrhythmia treatment efficacy

Data from the Antiarrythmics versus Implantable Defibrillators (AVID) Study

Michael A. Brodsky, John McAnulty, Douglas P. Zipes, Christina Baessler, Alfred P. Hallstrom

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: In survivors of life-threatening ventricular tachycardia (VT), a history of CHF (HxCHF) before the VT episode may provide different prognostic information than their measured left ventricular ejection fraction (LVEF). Methods: We evaluated outcomes from patients in the AVID study. Patients were included in the study if they presented with ventricular fibrillation, VT with syncope or VT with hemodynamic compromise, and LVEF ≤40%. Treatment options included implantable cardioverter defibrillator (ICD) or antiarrhythmic drugs (AAD), usually amiodarone. Results: As expected, a HxCHF is associated with an increased and high risk of arrhythmic and nonarrhythmic death. However, an interaction was observed between arrhythmia treatment (ICD or AAD) and HxCHF status: the survival advantage with an ICD, as compared with AAD therapy, is largely restricted to HxCHF patients. Conclusions: The ICD is no better than AAD therapy in preventing arrhythmic death in patients with no HxCHF. In this data set, a HxCHF is somewhat more accurate in predicting prognosis and the response to therapy than a reduced LVEF.

Original languageEnglish
Pages (from-to)724-730
Number of pages7
JournalAmerican Heart Journal
Volume152
Issue number4
DOIs
StatePublished - Oct 2006

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Implantable Defibrillators
Anti-Arrhythmia Agents
Cardiac Arrhythmias
Ventricular Tachycardia
Heart Failure
Stroke Volume
Drug Therapy
Amiodarone
Syncope
Ventricular Fibrillation
Survivors
Therapeutics
Hemodynamics
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

A history of heart failure predicts arrhythmia treatment efficacy : Data from the Antiarrythmics versus Implantable Defibrillators (AVID) Study. / Brodsky, Michael A.; McAnulty, John; Zipes, Douglas P.; Baessler, Christina; Hallstrom, Alfred P.

In: American Heart Journal, Vol. 152, No. 4, 10.2006, p. 724-730.

Research output: Contribution to journalArticle

Brodsky, Michael A. ; McAnulty, John ; Zipes, Douglas P. ; Baessler, Christina ; Hallstrom, Alfred P. / A history of heart failure predicts arrhythmia treatment efficacy : Data from the Antiarrythmics versus Implantable Defibrillators (AVID) Study. In: American Heart Journal. 2006 ; Vol. 152, No. 4. pp. 724-730.
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