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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
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K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
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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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Abstract
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Ivabradine is not associated with higher risk of new onset atrial fibrillation among patients with Cardiac Resynchronization Therapy
Session:
Posters 5 - Écran 05 - IC - Terapêutica
Speaker:
James Milner
Congress:
CPC 2018
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.4 Chronic Heart Failure – Treatment
Session Type:
Posters
FP Number:
---
Authors:
James Milner; Ana Vera Marinho; José Luís Costa Martins; Natália António; Miguel Ventura; João Cristóvão; Luis Elvas; Mariano Pêgo
Abstract
<p><strong>Background: </strong>Several recent trials have reported a higher incidence of new onset atrial fibrillation (AF) among patients medicated with Ivabradine. However, there is limited information on the safety profile of this drug in Cardiac Resynchronization Therapy (CRT) recipients, as well as the benefit of ivabradine in this context.</p> <p><strong>Purpose: </strong>To evaluate the impact of Ivabradine therapy in patients with heart failure (HF) submitted to CRT regarding new onset AF and clinical outcomes.</p> <p><strong>Population and methods: </strong>Single-center retrospective study of 175 consecutive patients submitted to CRT after widespread introduction of ivabradine in Portugal, in sinus rhythm at the time of the device implantation (between 2011 and 2015). The population was divided into two groups: A) Medicated with Ivabradine (N=34) and B) Without Ivabradine therapy (N=141). Baseline demographic and clinical characteristics were compared. The primary co-endpoints were progression to new onset AF, readmission due to decompensated HF and all-cause mortality, with a mean follow-up of 3.7±1.4 years.</p> <p><strong>Results: </strong>In this cohort, 67% of patients were male, and patients in group A were significantly younger (59±11 vs 66±10 years, p<0.0005). Patients medicated with Ivabradine showed a trend to higher proportion of nonischemic cardiomyopathy (77% vs 59%, p=0.071). Patients were treated with disease-modifying HF drugs in similar proportions in both groups, with a similar prevalence of arterial hypertension, type 2 d<em>iabetes mellitus</em> and chronic kidney disease but a higher prevalence of dyslipidemia in group B (80% vs 53%, p=0.002). During the follow-up, new onset AF occurred in 12% of patients in group A and 23% in group B (p=0.157), with similar time between device implantation and AF development in both groups (2.8±1.5 and 2.5±1.4 years respectively, p=0.234) and similar Kaplan-Meier curves (Log Rank p=0.147). Readmission due to decompensated HF was comparable in both groups (27% vs 30%, p=0.721) and there was no difference in all-cause mortality (3% in group A vs 10% in group B, p=0.188).</p> <p><strong>Conclusions:</strong> Heart rate control with Ivabradine seems to be a safe therapeutic option in HF patients submitted to CRT. Development of new onset AF occurs slowly after CRT, and ivabradine use doesn’t seem to be associated with a higher risk of new onset AF.</p>
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