Abstract 17516: Change of Physical Activity After Inappropriate Shock Therapies in Japanese Patients With Implantable Cardioverter Defibrillator
Introduction: Inappropriate shocks are common and significant problems in patients with implantable cardioverter defibrillator (ICD). However, little is known about the relationship between physical activities and inappropriate shocks in patients with ICD. Physical activity data are collected automatically by ICDs. This study was designed to determine the change of physical activities after and the predictors of inappropriate shock therapies in Japanese patients with ICD.
Hypothesis: Inappropriate shock therapies may reduce the physical activities of ICD patients.
Methods: We examined the database of remote monitoring systems of ICD patients at a single center in Japan. The physical activities one month before and after inappropriate shocks due to atrial fibrillation (AF) were analyzed. Fisher’s exact test were used for discrete variables. Multivariate Cox regression analysis with the forward selection method was used to find predictors for inappropriate shocks.
Results: A total of 172 Japanese patients were enrolled in this study (age 61±13 years, male 74%). Sixty seven patients (39%) received an ICD for secondary prevention of sudden cardiac death. Fifty patients (29%) had atrial fibrillation (AF). After a mean of 25±15 months, 11 patients (6.4%) experienced an inappropriate shock. Causes of inappropriate shocks were AF (9) and supraventricular tachycardia (2). Inappropriate shocks reduced the physical activities by forty percent. AF (82% vs. 25%, P<0.001), ventricular pacing (VP) <5% (91% vs. 62%, p=0.047) and single chamber ICD (36% vs. 5.6%, p=0.0049) were more prevalent in these patients. AF (Hazard ratio: 16.88, 95% Confidence interval: 2.99-94.19, P=0.0014) and VP<5% (Hazard ratio: 10.01, 95% Confidence interval: 1.06-94.71, P=0.045) were the independent predictors of inappropriate shocks.
Conclusions: Inappropriate shock therapies reduced the physical activities of ICD patients. AF and very low ventricular pacing percentiles strongly predict inappropriate shock therapies. The strict rate-control of AF using remote monitoring systems should be considered to keep the physical activities and reduce the incidence of inappropriate ICD shock therapies in this population.
- Activities of daily living
- Physical activity and exercise
- Implantable cardiovertor defibrillator
- Quality of life
Author Disclosures: Y. Kondo: Research Grant; Significant; St. Jude Medical, Biotronik. M. Ueda: None. M. Nakano: None. K. Miyazawa: None. M. Nakano: None. T. Hayashi: None. Y. Kobayashi: Research Grant; Significant; St. Jude Medical, Biotronik Japan, Boston Scientific.
- © 2016 by American Heart Association, Inc.