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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Who are the long-QT syndrome patients who receive an implantable cardioverter-defibrillator and what happens to them?: Data from the European Long-QT syndrome implantable cardioverter-defibrillator (LQTS ICD) registry
Circulation, Volume 122, No. 13, Year 2010
Notification
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Description
Background-: A rapidly growing number of long-QT syndrome (LQTS) patients are being treated with an implantable cardioverter-defibrillator (ICD). ICDs may pose problems, especially in the young. We sought to determine the characteristics of the LQTS patients receiving an ICD, the indications, and the aftermath. Methods And Results-: The study population included 233 patients. Beginning in 2002, data were collected prospectively. Female patients (77%) and LQT3 patients (22% of genotype positive) were overrepresented; mean QTc was 516±65 milliseconds; mean age at implantation was 30±17 years; and genotype was known in 59% of patients. Unexpectedly, 9% of patients were asymptomatic before implantation. Asymptomatic patients, almost absent among LQT1 and LQT2 patients, represented 45% of LQT3 patients. Patients with cardiac symptoms made up 91% of all study participants, but only 44% had cardiac arrest before ICD implantation. In addition, 41% of patients received an ICD without having first been on LQTS therapy. During follow-up, 4.6±3.2 years, at least 1 appropriate shock was received by 28% of patients, and adverse events occurred in 25%. Appropriate ICD therapies were predicted by age <20 years at implantation, a QTc >500 milliseconds, prior cardiac arrest, and cardiac events despite therapy; within 7 years, appropriate shocks occurred in no patients with none of these factors and in 70% of those with all factors. Conclusions-: Reflecting previous concepts, ICDs were implanted in some LQTS patients whose high risk now appears questionable. Refined criteria for implantation, reassessment of pros and cons, ICD reprogramming, and consideration for other existing therapeutic options are necessary. © 2010 American Heart Association, Inc.
Authors & Co-Authors
Schwartz, Peter J.
Italy, Pavia
Università Degli Studi Di Pavia
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Italy, Milan
Irccs Istituto Auxologico Italiano
South Africa, Stellenbosch
Stellenbosch University
South Africa, Cape Town
University of Cape Town
Saudi Arabia, Riyadh
College of Medicine
Spazzolini, Carla
Italy, Pavia
Università Degli Studi Di Pavia
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Priori, Silvia G.
Italy, Pavia
Istituti Clinici Scientifici Maugeri Spa – sb
United States, New York
New York University
CROTTI, L.
Italy, Pavia
Università Degli Studi Di Pavia
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Vicentini, Alessandro
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Landolina, Maurizio
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Gasparini, Maurizio
Italy, Rozzano
Humanitas Research Hospital
Wilde, Arthur A.M.
Netherlands, Amsterdam
Universiteit Van Amsterdam
Knops, Reinoud E.
Netherlands, Amsterdam
Universiteit Van Amsterdam
Denjoy, Isabelle
France, Paris
Hôpital Lariboisiere Ap-hp
Toivonen, Lauri K.
Finland, Helsinki
Helsinki University Hospital
Mönnig, Gerold
Germany, Munster
Universitätsklinikum Münster
Al-Fayyadh, Majid
Saudi Arabia, Riyadh
King Faisal Specialist Hospital and Research Centre
Jordaens, Luc J.L.M.
Netherlands, Rotterdam
Erasmus Mc
Borggrefe, Martin M.
Germany, Mannheim
Universitätsklinikum Mannheim
Holmgren, Christina
Sweden, Gothenburg
Sahlgrenska Universitetssjukhuset
Brugada, Pedro
Belgium, Jette
Universitair Ziekenhuis Brussel
de Roy, Luc J.M.
Belgium, Dinant
Chu Dinant Godinne | Ucl Namur
Hohnloser, Stefan Hans
Germany, Frankfurt am Main
Goethe-universität Frankfurt am Main
Brink, Paul A.
South Africa, Stellenbosch
Stellenbosch University
Statistics
Citations: 268
Authors: 20
Affiliations: 20
Identifiers
Doi:
10.1161/CIRCULATIONAHA.110.950147
ISSN:
00097322
e-ISSN:
15244539
Research Areas
Genetics And Genomics
Noncommunicable Diseases
Study Design
Cross Sectional Study
Cohort Study
Participants Gender
Female