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CPC 2018
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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
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0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Long-term clinical outcomes of transvenous vs subcutaneous implantable cardioverter defibrillators: a propensity score matched analysis
Session:
Posters 1 - Écran 01 - Arritmologia - Dispositivos
Speaker:
Daniel Jorge Nascimento Matos
Congress:
CPC 2018
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.2 Implantable Cardioverter / Defibrillator
Session Type:
Posters
FP Number:
---
Authors:
Daniel Nascimento Matos; João Mesquita; Diogo Cavaco; António Ferreira; Gustavo Da Rocha Rodrigues; Pedro Lopes Do Carmo; Francisco Moscoso Costa; João Carmo; Francisco Bello Morgado; Miguel Mendes; Pedro Adragão
Abstract
<p><strong>Background:</strong> A direct comparison between transvenous and subcutaneous implantable cardioverter defibrillators (TV-ICD, S-ICD, respectively) long-term clinical outcomes has been scarcely reported.</p> <p><strong>Objective:</strong> To compare long-term safety and efficacy of TV-ICD vs S-ICD in a propensity matched population.</p> <p><strong>Methods:</strong> Single-center observational registry including 845 consecutive patients who underwent S-ICD/TV-ICD implantation for either primary or secondary prevention of SCD (2007-2016). Safety and efficacy outcomes were defined as delivery of inappropriate shocks (IS) and prevention of SCD, respectively. Following adjustment for age, gender, primary/secondary prevention, ischemic etiology, atrial fibrillation (AF), left ventricular systolic dysfunction and current beta-blocker therapy, propensity-score (PS) matched 65 S-ICD with 130 TV-ICD patients in a 1:2 fashion, respectively (Fig A).</p> <p><strong>Results:</strong> Over a median 5-year (IQR 3-7) follow-up, 28% of TV-ICD patients received appropriate therapies vs. 21% in the S-ICD group (P=0.170) (Fig B,C) - yearly rates of appropriate shock delivery was 7%/year in both groups (P=0.999) All VT/VF episodes were adequately treated. IS delivery was similar between TV-ICD and S-ICD groups (13% vs. 16%, respectively (P=0.524)), although driven by significantly different causes (Fig B). Annual IS delivery rate was 3%/year vs 6%/year for TV-ICD and S-ICD groups, respectively (P=0.179) (Figure D). AF was the only independent predictor of IS delivery (HR 3.74 95% CI 1.79-7.79 (P<0.001)).</p> <p><strong>Conclusion:</strong> TV-ICD and S-ICD appear equally safe and effective in the long-term prevention of SCD. AF was an independent predictor of IS delivery</p>
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