Right bundle branch block predicts appropriate implantable cardioverter defibrillator therapies in patients with non-Iischemic dilated cardiomyopathy and a prophylactic implantable cardioverter defibrillator

Background: the benefit of prophylactic implantable cardioverter defibrillators (ICDs) in patients with severe systolic dysfunction of non-ischemic origin is still unclear, and the identification of patients at risk for sudden cardiac death remains a major challenge. Aims/Methods: we retrospectively...

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Autores: Jiménez-Blanco Bravo, Marta, Alonso Salinas, Gonzalo Luis, Parra Esteban, Carolina, Toquero Ramos, Jorge, Amores Luque, Miguel, Zamorano Gómez, José Luis, García-Izquierdo, Eusebio, Álvarez-García, Jesús, Fernández Lozano, Ignacio, Castro Urda, Víctor
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Universidad Pública de Navarra
Repositorio:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
OAI Identifier:oai:academica-e.unavarra.es:2454/52374
Acceso en línea:https://hdl.handle.net/2454/52374
Access Level:acceso abierto
Palabra clave:Implantable cardioverter defibrillator
Non-ischemic dilated cardiomyopathy
Primary prevention
Right bundle branch block
Sudden cardiac death
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spelling Right bundle branch block predicts appropriate implantable cardioverter defibrillator therapies in patients with non-Iischemic dilated cardiomyopathy and a prophylactic implantable cardioverter defibrillatorJiménez-Blanco Bravo, MartaAlonso Salinas, Gonzalo LuisParra Esteban, CarolinaToquero Ramos, JorgeAmores Luque, Miguel Zamorano Gómez, José LuisGarcía-Izquierdo, Eusebio Álvarez-García, JesúsFernández Lozano, IgnacioCastro Urda, VíctorImplantable cardioverter defibrillatorNon-ischemic dilated cardiomyopathyPrimary preventionRight bundle branch blockSudden cardiac deathBackground: the benefit of prophylactic implantable cardioverter defibrillators (ICDs) in patients with severe systolic dysfunction of non-ischemic origin is still unclear, and the identification of patients at risk for sudden cardiac death remains a major challenge. Aims/Methods: we retrospectively reviewed all consecutive patients with non-ischemic dilated cardiomyopathy (NICM) who underwent prophylactic ICD implantation between 2008 and 2020 in two tertiary centers. Our main goal was to identify the predictors of appropriate ICD therapies (anti-tachycardia pacing [ATP] and/or shocks) in this cohort of patients. Results: a total of 224 patients were included. After a median follow-up of 51 months, 61 patients (27.2%) required appropriate ICD therapies. Patients with appropriate ICD therapies were more frequently men (87% vs. 69%, p = 0.006), of younger age (59 years, (53-65) vs. 64 years, (57-70); p = 0.02), showed more right bundle branch blocks (RBBBs) (15% vs. 4%, p = 0.007) and less left bundle branch blocks (LBBBs) (26% vs. 47%, p = 0.005) in the ECG, and had higher left ventricular end-diastolic (100 mL/m2, (90-117) vs. 86, (71-110); p = 0.011) and systolic volumes (72 mL/m2, (59-87) vs. 61, (47-81), p = 0.05). In a multivariate competing-risks regression analysis, RBBB (HR 2.26, CI 95% 1.02-4.98, p = 0.043) was identified as an independent predictor of appropriate ICD therapies. Conclusion: RBBBs may help to identify patients with NICM at high risk of ventricular arrhythmias and requiring ICD intervention.MDPICiencias de la SaludOsasun Zientziak2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2454/52374reponame:Academica-e. Repositorio Institucional de la Universidad Pública de Navarrainstname:Universidad Pública de NavarraInglés© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:academica-e.unavarra.es:2454/523742026-06-17T12:41:47Z
dc.title.none.fl_str_mv Right bundle branch block predicts appropriate implantable cardioverter defibrillator therapies in patients with non-Iischemic dilated cardiomyopathy and a prophylactic implantable cardioverter defibrillator
title Right bundle branch block predicts appropriate implantable cardioverter defibrillator therapies in patients with non-Iischemic dilated cardiomyopathy and a prophylactic implantable cardioverter defibrillator
spellingShingle Right bundle branch block predicts appropriate implantable cardioverter defibrillator therapies in patients with non-Iischemic dilated cardiomyopathy and a prophylactic implantable cardioverter defibrillator
Jiménez-Blanco Bravo, Marta
Implantable cardioverter defibrillator
Non-ischemic dilated cardiomyopathy
Primary prevention
Right bundle branch block
Sudden cardiac death
title_short Right bundle branch block predicts appropriate implantable cardioverter defibrillator therapies in patients with non-Iischemic dilated cardiomyopathy and a prophylactic implantable cardioverter defibrillator
title_full Right bundle branch block predicts appropriate implantable cardioverter defibrillator therapies in patients with non-Iischemic dilated cardiomyopathy and a prophylactic implantable cardioverter defibrillator
title_fullStr Right bundle branch block predicts appropriate implantable cardioverter defibrillator therapies in patients with non-Iischemic dilated cardiomyopathy and a prophylactic implantable cardioverter defibrillator
title_full_unstemmed Right bundle branch block predicts appropriate implantable cardioverter defibrillator therapies in patients with non-Iischemic dilated cardiomyopathy and a prophylactic implantable cardioverter defibrillator
title_sort Right bundle branch block predicts appropriate implantable cardioverter defibrillator therapies in patients with non-Iischemic dilated cardiomyopathy and a prophylactic implantable cardioverter defibrillator
dc.creator.none.fl_str_mv Jiménez-Blanco Bravo, Marta
Alonso Salinas, Gonzalo Luis
Parra Esteban, Carolina
Toquero Ramos, Jorge
Amores Luque, Miguel
Zamorano Gómez, José Luis
García-Izquierdo, Eusebio
Álvarez-García, Jesús
Fernández Lozano, Ignacio
Castro Urda, Víctor
author Jiménez-Blanco Bravo, Marta
author_facet Jiménez-Blanco Bravo, Marta
Alonso Salinas, Gonzalo Luis
Parra Esteban, Carolina
Toquero Ramos, Jorge
Amores Luque, Miguel
Zamorano Gómez, José Luis
García-Izquierdo, Eusebio
Álvarez-García, Jesús
Fernández Lozano, Ignacio
Castro Urda, Víctor
author_role author
author2 Alonso Salinas, Gonzalo Luis
Parra Esteban, Carolina
Toquero Ramos, Jorge
Amores Luque, Miguel
Zamorano Gómez, José Luis
García-Izquierdo, Eusebio
Álvarez-García, Jesús
Fernández Lozano, Ignacio
Castro Urda, Víctor
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Ciencias de la Salud
Osasun Zientziak
dc.subject.none.fl_str_mv Implantable cardioverter defibrillator
Non-ischemic dilated cardiomyopathy
Primary prevention
Right bundle branch block
Sudden cardiac death
topic Implantable cardioverter defibrillator
Non-ischemic dilated cardiomyopathy
Primary prevention
Right bundle branch block
Sudden cardiac death
description Background: the benefit of prophylactic implantable cardioverter defibrillators (ICDs) in patients with severe systolic dysfunction of non-ischemic origin is still unclear, and the identification of patients at risk for sudden cardiac death remains a major challenge. Aims/Methods: we retrospectively reviewed all consecutive patients with non-ischemic dilated cardiomyopathy (NICM) who underwent prophylactic ICD implantation between 2008 and 2020 in two tertiary centers. Our main goal was to identify the predictors of appropriate ICD therapies (anti-tachycardia pacing [ATP] and/or shocks) in this cohort of patients. Results: a total of 224 patients were included. After a median follow-up of 51 months, 61 patients (27.2%) required appropriate ICD therapies. Patients with appropriate ICD therapies were more frequently men (87% vs. 69%, p = 0.006), of younger age (59 years, (53-65) vs. 64 years, (57-70); p = 0.02), showed more right bundle branch blocks (RBBBs) (15% vs. 4%, p = 0.007) and less left bundle branch blocks (LBBBs) (26% vs. 47%, p = 0.005) in the ECG, and had higher left ventricular end-diastolic (100 mL/m2, (90-117) vs. 86, (71-110); p = 0.011) and systolic volumes (72 mL/m2, (59-87) vs. 61, (47-81), p = 0.05). In a multivariate competing-risks regression analysis, RBBB (HR 2.26, CI 95% 1.02-4.98, p = 0.043) was identified as an independent predictor of appropriate ICD therapies. Conclusion: RBBBs may help to identify patients with NICM at high risk of ventricular arrhythmias and requiring ICD intervention.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2454/52374
url https://hdl.handle.net/2454/52374
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
instname:Universidad Pública de Navarra
instname_str Universidad Pública de Navarra
reponame_str Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
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