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Cardiology Xagena

Incidence of ventricular arrhythmic events in patients with chronic kidney disease and implantable cardioverter-defibrillator


A study has examined patients with chronic kidney disease ( CKD ) in stages 1, 2, 3 and 4, left ventricular dysfunction and automatic implantable cardioverter-defibrillator ( ICD ).
The goal was to record the appropriate therapies, ATP ( Anti-tachycardia Therapy Pacing ) and shock events during the 12 months of follow-up and compare the incidence and severity of these at different stages of chronic kidney disease.

Seventy-six patients were evaluated once every three months till one year of follow-up. The arrhythmic events were assessed at each follow-up visit.

Comparing the groups, patients with chronic kidney disease stage 4 had a higher number of ATP ( 45.1±4.4 ) and shock ( 33.3±5.0 ) events compared to other groups ( P less than 0.0001 for both comparisons in relation to other groups ).

Along the 12 months, 69% received anti-tachycardia therapy pacing and 63% were treated with shock, P less than 0.0001 by Log-rank/Mantel-Haenszel test compared to the other groups.
Regarding the ATP events, patients with chronic kidney disease stage 4 showed the hazard ratio ( HR ) of 11.800, with a confidence interval of 95% ( CI 95% ) from 3.673 to 37,930, P less than 0.0001 versus patients with chronic kidney disease stage 1; HR of 7.957, with a CI 95% from 2.578 to 24.570, P less than 0.0001 versus patients with chronic kidney disease stage 2; and HR of 2.902, with a CI 95% 1.054-7.986, P=0.0391 versus patients with chronic kidney disease stage 3.

In relation to the shock events, patients with chronic kidney disease stage 4 showed the HR of 20,010, with a CI 95% from 5.262 to 76.080, P less than 0.0001 versus patients with chronic kidney disease stage 1; HR of 10.060 with a CI 95% 3.026-33.450, P=0.0001 versus patients with chronic kidney disease stage 2; and HR of 2.880, with a CI 95% 1.029-8.060, P=0.0323 vs. patients with chronic kidney disease stage 3.

In conclusion, the results suggest that the more advanced the stage of chronic kidney disease higher the hazard ratio of anti-tachycardia therapy and shock events. ( Xagena )

Kiuchi MG et al, Int J Cardiol 2016; Epub ahead of print

XagenaMedicine_2016



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