Abstract 11961: Natriuretic Peptides Change after Defibrillation Threshold Testing with Risk of Further Ventricular Tachycardia Event
Background: Defibrillation threshold testing (DFT) is used to confirm effective device function during implantable cardioverter defibrillator (ICD) insertion. The effects of DFT on atrial and ventricular function are uncertain. Natriuretic peptides are markers of atrial and ventricular hemodynamic stress. We observe the changes of natriuretic peptides levels after DFT and further ventricular tachycardia events.
Methods: Atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and c-type natriuretic peptide (CNP) were measured in 21 patients (mean age 61±13 years; 33% women) undergoing ICD insertion. The blood samples were drawn at preinsertion, at 30 minutes, at 60 minutes, and at 24 hours after DFT. The patients were divided into two groups according to whether ventricular tachycardia occurred in 14 months. The change of biomarker levels were compared in patients with and without further ventricular tachycardia.
Results: The ANP levels were increased significantly after DFT among patients with further ventricular tachycardia in 14 months (P<0.05). The BNP and CNP levels did not change significantly after DFT among each group. The area under curve was 0.82 for the change of ANP concentration in 30 minutes (Δ30minANP) determining further ventricular events. The Δ30minANP cutoff value was 0.51pg/ml with sensitivity 0.83 and specificity 0.68. Multivariable analysis confirmed patients with Δ30minANP more than 0.51pg/ml have higher risk of further ventricular events (hazard ratio 27.94, 95% confidence interval: 2.13-366.46, P=0.01).
Conclusions: The changes of ANP, BNP, and CNP concentrations after DFT during ICD insertion were observed. The increase of ANP concentration after DFT may predict further ventricular event after ICD insertion. The underlying mechanism association between ANP and ventricular tachycardia need further investigation.
- Implantable cardioconvert defibrillator
- Atrial natriuretic peptide (factor)
- Ventricular tachycardia
- © 2012 by American Heart Association, Inc.