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Association between implantable cardioverter-defibrillator and survival in patients awaiting heart transplantation: A meta-analysis and systematic review

BACKGROUND: Patients with end-stage heart failure are at high risk for sudden cardiac death. However, implantable cardioverter-defibrillator (ICD) is not routinely implanted given the high competing risk of pump failure. A unique population worth separate consideration are patients with end-stage he...

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Autores principales: Lin, Andrew Y., Duran, Jason M., Sykes, Alexandra, Darden, Douglas, Urey, Marcus, Hsu, Jonathan C., Adler, Eric D., Birgersdotter-Green, Ulrika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8710633/
https://www.ncbi.nlm.nih.gov/pubmed/34988520
http://dx.doi.org/10.1016/j.hroo.2021.09.013
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author Lin, Andrew Y.
Duran, Jason M.
Sykes, Alexandra
Darden, Douglas
Urey, Marcus
Hsu, Jonathan C.
Adler, Eric D.
Birgersdotter-Green, Ulrika
author_facet Lin, Andrew Y.
Duran, Jason M.
Sykes, Alexandra
Darden, Douglas
Urey, Marcus
Hsu, Jonathan C.
Adler, Eric D.
Birgersdotter-Green, Ulrika
author_sort Lin, Andrew Y.
collection PubMed
description BACKGROUND: Patients with end-stage heart failure are at high risk for sudden cardiac death. However, implantable cardioverter-defibrillator (ICD) is not routinely implanted given the high competing risk of pump failure. A unique population worth separate consideration are patients with end-stage heart failure awaiting heart transplantation, as prolonged survival improves the chances of receiving transplant. OBJECTIVE: To compare clinical outcomes of heart failure patients with and without an ICD awaiting heart transplant. METHODS: We performed an extensive literature search and systematic review of studies that compared end-stage heart failure patients with and without an ICD awaiting heart transplantation. We separately assessed the rates of total mortality, sudden cardiac death, nonsudden cardiac death, and heart transplantation. Risk ratio (RR) and 95% confidence intervals were measured using the Mantel-Haenszel method. The random effects model was used owing to heterogeneity across study cohorts. RESULTS: Ten studies with a total of 36,112 patients were included. A total of 62.5% of patients had an ICD implanted. Patients with an ICD had decreased total mortality (RR 0.60, 95% CI 0.51–0.71, P < .00001) and sudden cardiac death (RR 0.27, 95% CI 0.11–0.66, P = .004) and increased rates of heart transplantation (RR 1.09, 95% CI 1.05–1.14, P < .0001). There was no difference in prevalence of nonsudden cardiac death (RR 0.68, 95% CI 0.44–1.04, P = .07). CONCLUSION: ICD implantation is associated with improved outcomes in patients awaiting heart transplant, characterized by decreased total mortality and sudden cardiac death as well as higher rates of heart transplantation.
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spelling pubmed-87106332022-01-04 Association between implantable cardioverter-defibrillator and survival in patients awaiting heart transplantation: A meta-analysis and systematic review Lin, Andrew Y. Duran, Jason M. Sykes, Alexandra Darden, Douglas Urey, Marcus Hsu, Jonathan C. Adler, Eric D. Birgersdotter-Green, Ulrika Heart Rhythm O2 Implantable Devices BACKGROUND: Patients with end-stage heart failure are at high risk for sudden cardiac death. However, implantable cardioverter-defibrillator (ICD) is not routinely implanted given the high competing risk of pump failure. A unique population worth separate consideration are patients with end-stage heart failure awaiting heart transplantation, as prolonged survival improves the chances of receiving transplant. OBJECTIVE: To compare clinical outcomes of heart failure patients with and without an ICD awaiting heart transplant. METHODS: We performed an extensive literature search and systematic review of studies that compared end-stage heart failure patients with and without an ICD awaiting heart transplantation. We separately assessed the rates of total mortality, sudden cardiac death, nonsudden cardiac death, and heart transplantation. Risk ratio (RR) and 95% confidence intervals were measured using the Mantel-Haenszel method. The random effects model was used owing to heterogeneity across study cohorts. RESULTS: Ten studies with a total of 36,112 patients were included. A total of 62.5% of patients had an ICD implanted. Patients with an ICD had decreased total mortality (RR 0.60, 95% CI 0.51–0.71, P < .00001) and sudden cardiac death (RR 0.27, 95% CI 0.11–0.66, P = .004) and increased rates of heart transplantation (RR 1.09, 95% CI 1.05–1.14, P < .0001). There was no difference in prevalence of nonsudden cardiac death (RR 0.68, 95% CI 0.44–1.04, P = .07). CONCLUSION: ICD implantation is associated with improved outcomes in patients awaiting heart transplant, characterized by decreased total mortality and sudden cardiac death as well as higher rates of heart transplantation. Elsevier 2021-12-17 /pmc/articles/PMC8710633/ /pubmed/34988520 http://dx.doi.org/10.1016/j.hroo.2021.09.013 Text en © 2021 Heart Rhythm Society. Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Implantable Devices
Lin, Andrew Y.
Duran, Jason M.
Sykes, Alexandra
Darden, Douglas
Urey, Marcus
Hsu, Jonathan C.
Adler, Eric D.
Birgersdotter-Green, Ulrika
Association between implantable cardioverter-defibrillator and survival in patients awaiting heart transplantation: A meta-analysis and systematic review
title Association between implantable cardioverter-defibrillator and survival in patients awaiting heart transplantation: A meta-analysis and systematic review
title_full Association between implantable cardioverter-defibrillator and survival in patients awaiting heart transplantation: A meta-analysis and systematic review
title_fullStr Association between implantable cardioverter-defibrillator and survival in patients awaiting heart transplantation: A meta-analysis and systematic review
title_full_unstemmed Association between implantable cardioverter-defibrillator and survival in patients awaiting heart transplantation: A meta-analysis and systematic review
title_short Association between implantable cardioverter-defibrillator and survival in patients awaiting heart transplantation: A meta-analysis and systematic review
title_sort association between implantable cardioverter-defibrillator and survival in patients awaiting heart transplantation: a meta-analysis and systematic review
topic Implantable Devices
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8710633/
https://www.ncbi.nlm.nih.gov/pubmed/34988520
http://dx.doi.org/10.1016/j.hroo.2021.09.013
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