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A. Basics
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05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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32. Cardiovascular Nursing
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Heart rate score: a simple and useful predictor for clinical outcomes in Heart Failure
Session:
Comunicações Orais (Sessão 8) - Arritmias 2 - Pacing e dispositivos cardíacos
Speaker:
M. Inês Barradas
Congress:
CPC 2022
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.2 Implantable Cardioverter / Defibrillator
Session Type:
Comunicações Orais
FP Number:
---
Authors:
m. Inês Barradas; Fabiana Duarte; Luís Resendes de Oliveira; Cátia Serena; António Xavier Fontes; André Viveiros Monteiro; Carina Machado; Raquel Dourado; Emília Santos; Nuno Pelicano; Miguel Pacheco; Anabela Tavares; Dinis Martins
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman""><span style="color:#000000">Background: Heart rate score (HRS) is a simple index obtained from implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRT-D) and is defined as the percentage of all atrial-paced and sensed events in the single tallest 10 beats/min device histogram bin. It serves as a measure of impaired heart rate variability and HRS ≥ 70% may be associated with arrhythmic events and mortality in heart failure (HF) patients. </span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman""><span style="color:#000000">Purpose: We hypothesized that HRS ≥ 70% is associated not only with arrhythmic events and mortality, but also with HF decompensations and hospitalizations in HF patients.</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman""><span style="color:#000000">Methods: HRS was calculated from remote monitoring in 103 HF patients with ICD or CRT-D. Two groups of patients were defined: HRS ≥ 70% (group 1) and HRS < 70% (group 2). Primary outcome was defined as HF hospitalizations and related admissions to emergency department (ED) and secondary outcome as device total and appropriate number of shocks, ventricular fibrillation (VF) episodes and cardiovascular (CV) death. </span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman""><span style="color:#000000">Results: Mean age was 64,39 ± 13.04 years, 69,9% were males and mean follow-up period was 61,65 ± 38,87 months. HF aetiology was idiopathic in 33,0% and ischemic in 30,1%. 61 (59,2%) patients had CRT-D and 42 (40,8%) ICD. Mean left ventricular ejection fraction was 33,62 ± 11,964% and mean HRS 51,07 ± 23,27%. Each patient had 1,23 ± 2,06 HF hospitalizations or related admissions to the ED, 3,04 ± 14,90 episodes of VF and 2,39 ± 8,936 device shocks. HRS was ≥ 70% in 55 (53,4%) patients (group 1) and < 70% in 48 (46,6%). Group 1 patients were more frequently males (p=0,017) and had more frequently coronary artery disease (p=0,035). HF hospitalizations and admissions to the ED were more common in group 1 (1,83 ± 2,35 vs 0,60 ± 1,52, p=0,002). Patients from group 1 had more episodes of non-sustained ventricular tachycardia (337,07 ± 755,90 vs 23,70 ± 58,82, p=0,001), VF episodes (9,15 ± 27,33 vs 0,52 ± 1,65, p=0,044) and appropriate (4,69 ± 9,594 vs 0,13 ± 0,344, p=0,004) and total device shocks (7,59 ± 15,945 vs 0,26 ± 0,541, p=0,004).CV death was higher in group 1 but without significance (2 patients in group 1 vs 0, p=0,177). HRS also correlated with composite outcome of number HF hospitalizations, HF related admissions to the ED, FV episodes and device shocks (r=0,495, p=0,001).</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman""><span style="color:#000000">Conclusion: HRS is a simple and easily obtained indexthat correlates with HF hospitalizations and related admissions to the ED, VF episodes and total and appropriate device shocks and may be used as a predictor for clinical outcomes. </span></span></span></p>
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