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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
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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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Prognostic importance of inappropriate shocks in patients with subcutaneous implantable defibrillator.
Session:
Posters 1 - Écran 3 - Arritmologia
Speaker:
Gustavo Rodrigues
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.2 Implantable Cardioverter / Defibrillator
Session Type:
Posters
FP Number:
---
Authors:
Gustavo Da Rocha Rodrigues; João Carmo; Diogo Cavaco; Pedro Lopes Do Carmo; Francisco Bello Morgado; Francisco Moscoso Costa; Maria Salomé Carvalho; António Xavier Fontes; Adriana Cavalcante; Pedro Adragão; Miguel Mendes
Abstract
<p><strong>Introduction </strong></p> <p>It has been previously reported that inappropriate transvenous implantable cardioverter-defibrillator shocks are correlated with an impaired prognosis. Subcutaneous implantable cardioverter-defibrillator (S-ICD), besides avoiding risks and complications associated with transvenous leads, could also circumvent the possibly injury of an endovascular shock. We aimed to access if inappropriate shocks are linked to an impaired prognosis in a population of S-ICD patients.</p> <p> </p> <p><strong>Methods and results</strong></p> <p>In a real world prospective registry of 100 patients who underwent S-ICD implant between 2009 and 2018, we evaluated the rate and cause of inappropriate shocks and its correlation with prognosis (total death), during a median follow-up of 32 [9;57] months. Most of the patients were male (79%), with a median age of 41 [24;56] years, 25% had atrial fibrillation (AF), 9% chronic kidney disease (GFR < 60 ml/min/1.73m<sup>2</sup>) and half have systolic dysfunction (Left ventricle ejection fraction < 55%) (table 1 ). S-ICD was implanted on primary prevention on most cases (71%), and hypertrophic cardiomyopathy was the main reason for implant (table1). There were a total of 19 patients with appropriate shocks and 19 patients with inappropriate shocks (29 inappropriate shocks in total). The main reasons for inappropriate shocks were supraventricular tachycardia (63%, 33% of those due to AF) and T wave oversensing (37%). Patients with inappropriate shocks are similar to the remaining population. Patients with non-compacted left ventricle or dilated cardiomyopathy had the highest relative incidence of inappropriate shocks (50% and 25% respectively; table 2). Total mortality during follow up was 7% and inappropriate shocks didn’t correlate with total death (p 0.37).</p> <p> </p> <p><strong>Conclusion</strong></p> <p>In our population of patients with an S-ICD, inappropriate shocks were mainly caused by supra-ventricular tachycardia, without correlation with an impaired prognosis. This finding highlights a possible advantage of this innovative system, needing further validation in a larger cohort.</p>
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