Skip Navigation

European Heart Journal 2002 23(11):901-907; doi:10.1053/euhj.2001.3073
Copyright © 2002 by the European Society of Cardiology.
This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (7)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Garcia-Moran, E.
Right arrow Articles by Brugada, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Garcia-Moran, E.
Right arrow Articles by Brugada, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Low recurrence of syncope in patients with inducible sustained ventricular tachyarrhythmias treated with an implantable cardioverter-defibrillator

E. Garcia-Moran, L. Montf1, A. Cuesta, M. Matas and J. Brugada

Arrhythmia Section, Cardiovascular Institute, Hospital Clínic Universitari, Barcelona, Spain

revised October 15, 2001; accepted October 17, 2001

Abstract

Aims To determine the effectiveness of the implantable cardioverter defibrillator (ICD) in preventing recurrence of syncope in patients with structural heart disease, previously unexplained syncope and inducible ventricular arrhythmias.

Methods Thirty-eight patients with syncope, structural heart disease and inducible arrhythmias had an ICD implanted. All ICDs delivered antitachycardia pacing and shocks of adjusted energy. Detection and therapy were programmed according to uniform criteria.

Results The mean age of the patients was 63±11 years and most of them were male (36/38). After a mean follow-up of 28±15 (4–61) months, six patients died and one underwent heart transplantation. Syncope recurred in three patients, but in none of them was it caused by an arrhythmic event. In 18 patients, 113 episodes of ventricular tachycardia/ventricular fibrillation were detected and appropriately treated by the ICD. The mean time from implant until first appropriate therapy was 18±14 months. The actuarial probability of receiving appropriate therapy was 20% and 42% at 12 and 24 months, respectively.

Conclusions In patients with unexplained syncope, structural heart disease and inducible arrhythmias, ICD prevents syncope associated with arrhythmic events. Frequent effective use of antitachycardia pacing and shocks of adjusted energy seem essential to this aim. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.

Key Words: Implantable cardioverter defibrillator, syncope, ventricular arrhythmias

f1 Correspondence: L. Mont, Arrhythmia Section, Cardiovascular Institute, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain.

References

  1. Mirowski M, Reid PR, Mower MM. Termination of malignant ventricular arrhythmias with an implantable automatic defibrillator in human beings. N Engl J Med. 1980;303:322–324[Web of Science][Medline]
  2. Reid PR, Mirowski M, Mower MM. Clinical evaluation of the internal automatic defibrillator survivors of sudden cardiac death. Am J Cardiol. 1983;51:1608–1613[CrossRef][Web of Science][Medline]
  3. N Engl J Med. 1997;337:1576–1583[Abstract/Free Full Text]
  4. Moss AJ, Hall J, Cannom DS. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med. 1996;335:1933–1940[Abstract/Free Full Text]
  5. Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G. A randomized study of the prevention of sudden death in patients with coronary artery disease. N Engl J Med. 1999;341:1882–1990[Abstract/Free Full Text]
  6. Gregoratos G, Cheitlin MD, Conill A. ACC/AHA guidelines for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Pacemaker Implantation). J Am Coll Cardiol. 1998;31:1175–1209[Free Full Text]
  7. Militianu A, Salacata A, Seibert K. Implantable cardioverter defibrillator utilization among device recipients presenting exclusively with syncope or near-syncope. J Cardiovasc Electrophysiol. 1997;8:1087–1097[Web of Science][Medline]
  8. Aguinaga L, Mont L, Anguera I, Valentino M, Matas M, Brugada J. Pacientes con cardiopatía estructural; síncope de etiología desconocida y arritmias inducibles tratados con desfibrilador implantable. Rev Esp Cardiol. 1998;51:566–571[Web of Science][Medline]
  9. Pires LA, May LM, Ravi S, Parry JT, Lal VR, Nino CL. Comparison of event rates and survival in patients with unexplained syncope without documented ventricular tachyarrhythmias versus patients with documented sustained ventricular tachyarrhythmias both treated with implantable cardioverter-defibrillators. Am J Cardiol. 2000;85:725–728[CrossRef][Web of Science][Medline]
  10. Andrews NP, Fogel RI, Pelargonio G, Evans JJ, Prystowsky EN. Implantable defibrillator event rates in patients with unexplained syncope and inducible sustained ventricular tachyarrhythmias. J Am Coll Cardiol. 1999;34:2023–2030[Abstract/Free Full Text]
  11. Epstein AE, Miles WM, Benditt DG. Personal and public safety issues related to arrhythmias that may affect consciousness: implications for regulation and physician recommendations. Circulation. 1996;94:1147–1166[Free Full Text]
  12. Curtis AB, Contie JB, Tucker KJ, Kubilis PS, Reilly RE, Woodard DA. Motor vehicle accidents in patients with an implantable cardioverter defibrillator. J Am Coll Cardiol. 1995;26:180–184[Abstract]
  13. Jung W, Lüderitz B. Quality of life and driving in recipients of the implantable-cardioverter defibrillator. Am J Cardiol. 1996;78:51–56[Web of Science][Medline]
  14. Brugada J, Mont L, Figueiredo M, Valentino M, Matas M, Navarro-López F. Enhanced detection criteria in implantable defibrillators. J Cardiovasc Electrophysiol. 1998;9:261–268[Web of Science][Medline]
  15. Link MS, Costeas XF, Griffith JL, Colburn CD, Estes NAM III, Wang PJ. High incidence of appropriate implantable cardioverter defibrillator therapy in patients with syncope of unknown etiology and inducible ventricular arrhythmias. J Am Coll Cardiol. 1997;29:370–375[Abstract]
  16. Kou WH, Calkins H, Lewis RR. Incidence of loss of consciousness during automatic implantable cardioverter defibrillator shocks. Ann Intern Med. 1991;115:942–945[Abstract/Free Full Text]
  17. Bänsch D, Brunn J, Castrucci M. Syncope in patients with an implantable cardioverter-defibrillator: Incidence; prediction; and implications for driving restrictions. J Am Coll Cardiol. 1998;31:608–615[Abstract/Free Full Text]
  18. Olatidoye AG, Verroneau J, Kluger J. Mechanisms of syncope in implantable cardioverter-defibrillator recipients who receive device therapies. Am J Cardiol. 1998;82:1372–1376[CrossRef][Web of Science][Medline]
  19. Mont L, Valentino M, Sambola A, Matas M, Aguinaga L, Brugada J. Arrhythmia recurrence in patients with a healed myocardial infarction who received an implantable defibrillator: analysis according to the clinical presentation. J Am Coll Cardiol. 1999;34:351–357[Abstract/Free Full Text]
  20. Schaumann A, von zur Mühlen F, Herse B, Gonska B, Kreuzer H. Empirical versus tested antitachycardia pacing in implantable cardioverter defibrillators. Circulation. 1998;97:66–74[Abstract/Free Full Text]
  21. Brugada J, Brugada P, Boersma L. On the mechanisms of ventricular tachycardia acceleration during programmed electrical stimulation. Circulation. 1991;83:1621–1629[Abstract/Free Full Text]
  22. Pinski SL, Fahy GH. The Proarrhythmic Potential of Implantable Cardioverter-Defibrillators. Circulation. 1995;92:1651–1664[Abstract/Free Full Text]
  23. Nasir N Jr, Pacifico A, Doyle TK, Earle NR, Hardage ML, Henry PD. Spontaneous ventricular tachycardia treated by antitachycardia pacing. Cadence Investigators. Am J Cardiol. 1997;79:820–822[CrossRef][Web of Science][Medline]
  24. Block M, Breithardt G. Optimizing defibrillation through improved waveforms. PACE. 1995;18:526–538

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 J Am Coll CardiolHome page
A. E. Epstein, J. P. DiMarco, K. A. Ellenbogen, N.A. M. Estes III, R. A. Freedman, L. S. Gettes, A. M. Gillinov, G. Gregoratos, S. C. Hammill, D. L. Hayes, et al.
ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons
J. Am. Coll. Cardiol., May 27, 2008; 51(21): e1 - e62.
[Full Text] [PDF]

Home page
 CirculationHome page
Writing Committee Members, A. E. Epstein, J. P. DiMarco, K. A. Ellenbogen, N.A. M. Estes III, R. A. Freedman, L. S. Gettes, A. M. Gillinov, G. Gregoratos, S. C. Hammill, et al.
ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons
Circulation, May 27, 2008; 117(21): e350 - e408.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
M. Abello and J. L. Merino
Incidence of syncope after ICD implantation: low or high?: reply
Eur. Heart J., October 2, 2006; 27(20): 2482 - 2482.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
E. G. Moran and L. Mont
Incidence of syncope after ICD implantation: low or high?
Eur. Heart J., October 2, 2006; 27(20): 2481 - 2482.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
Developed in Collaboration With the European Heart, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al.
ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death)
J. Am. Coll. Cardiol., September 5, 2006; 48(5): e247 - e346.
[Full Text] [PDF]

Home page
 EuropaceHome page
Writing Committee Members, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al.
ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society
Europace, September 1, 2006; 8(9): 746 - 837.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
M. Abello, J. L. Merino, R. Peinado, M. Gnoatto, M. A. Arias, M. Gonzalez-Vasserot, and J. A. Sobrino
Syncope following cardioverter defibrillator implantation in patients with spontaneous syncopal monomorphic ventricular tachycardia
Eur. Heart J., January 1, 2006; 27(1): 89 - 95.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (7)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Garcia-Moran, E.
Right arrow Articles by Brugada, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Garcia-Moran, E.
Right arrow Articles by Brugada, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?