15 results on '"M. Suleiman"'
Search Results
2. Non-ischemic sudden cardiac arrest: Role of 12 lead Holter, family screening and genetic testing.
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Blich M, Oron H, Darawsha W, Suleiman M, Avraham L, Asaad K, Boulos M, and Gepstein L
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- Adult, Female, Genetic Predisposition to Disease, Humans, Israel, Magnetic Resonance Imaging, Male, Prognosis, Retrospective Studies, Risk Factors, Death, Sudden, Cardiac, Electrocardiography, Ambulatory, Genetic Testing
- Abstract
Objective and Background: To evaluate the diagnostic and prognostic yield of a comprehensive protocol involving clinical and broad genetic testing in consecutive sudden cardiac arrest (SCA) population. Determining the pathogenesis of non-ischemic SCA is crucial for management and SCA prevention in other family members METHODS: Families with unexplained non-ischemic SCA event underwent rigorous clinical and genetic protocol after referral to our inherited arrhythmia clinic, during 2011-2017., Results: One hundred and four index cases, 29 ± 16 years, and 421 family members were studied. After a thorough evaluation, diagnosis was made in 80 (77%) of families. The most prevalent 47/104 (45%) diagnosis was inherited channelopathy. The genetic test was positive, in 37 /69 (54%) of patients. Using the Mann Whitney test, we found that electrocardiography (ECG) (effect size 0.5, p < .001), 12 lead Holter (effect size 0.33, p = .001) and family screening (effect size 0.4, p = .001) had the highest yield in reaching the final diagnosis. Family screening, genetic testing, and cardiac MRI were the exclusive modalities for final diagnosis in 14%, 9%, and 2% of families, respectively. Among 421 family members evaluated through cascade screening, 127 (30%), were diagnosed and medically treated. Nine family members from 25 (40%) patients who underwent implantable cardioverter defibrillator (ICD) implantation have experienced appropriate ICD shock., Conclusions: A rigorous, systematic protocol in a specialized inherited arrhythmia clinic has a high diagnostic and prognostic yield. ECG, 12 lead Holter and family screening significantly increased the diagnostic yield. In nine families, without genetic testing, the diagnosis would have been missed., (© 2021 Wiley Periodicals LLC.)
- Published
- 2021
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3. Arrhythmic burden among asymptomatic patients with ischemic cardiomyopathy and an implantable cardioverter-defibrillator.
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Sabbag A, Glikson M, Suleiman M, Boulos M, Goldenberg I, Beinart R, and Nof E
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- Aged, Arrhythmias, Cardiac complications, Arrhythmias, Cardiac epidemiology, Asymptomatic Diseases, Death, Sudden, Cardiac epidemiology, Death, Sudden, Cardiac etiology, Female, Follow-Up Studies, Humans, Incidence, Israel epidemiology, Male, Middle Aged, Prospective Studies, Survival Rate trends, Arrhythmias, Cardiac therapy, Cardiomyopathies complications, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Myocardial Ischemia complications, Primary Prevention methods
- Abstract
Background: The clinical benefit of primary prevention implantable cardioverter-defibrillator (ICD) therapy in asymptomatic patients (New York Heart Association [NYHA] functional class I) with ischemic cardiomyopathy and left ventricular dysfunction is continually disputed., Objective: The purpose of this study was to evaluate the incidence of ventricular arrhythmias, mortality rates, and appropriate device therapies by NYHA class in a prospective national ICD registry., Methods: The study comprised 1670 consecutive patients with ischemic cardiomyopathy who were implanted with a primary prevention ICD and enrolled in the prospective national Israeli ICD Registry from 2010. The risk for clinical and arrhythmic events was assessed by NYHA class., Results: Asymptomatic patients (NYHA I) composed 19% of the study cohort. Comparison according to NYHA class showed that the highest mortality rate was in the NYHA III-IV group vs NYHA I and NYHA II (10.5% vs 5.4% and 5.8%, respectively; log rank P = .003). Conversely, cumulative incidence of appropriate ICD therapies, corrected for death as a competing risk, were higher among patients with NYHA I (11% vs 7%; P = .021). In a multivariate model, NYHA I vs ≥II remained independently associated with a significant 2-fold risk for appropriate ICD therapy (hazard ratio 2.03; 95% confidence interval 1.28-3.24)., Conclusion: Our findings indicate that patients with ischemic cardiomyopathy without heart failure symptoms have a higher risk of appropriate ICD therapy compared with symptomatic patients after adjustment for the competing risk of death, suggesting possible incremental benefit of primary ICD implantation in this population., (Copyright © 2019. Published by Elsevier Inc.)
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- 2019
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4. Risk of death without appropriate defibrillator shock in patients with advanced renal dysfunction.
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Goldenberg I, Mor T, Nof E, Younis A, Berkovitch A, Rosso R, Barsheshet A, Suleiman M, and Beinart R
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- Aged, Clinical Decision-Making, Electric Countershock adverse effects, Electric Countershock mortality, Female, Heart Failure diagnosis, Heart Failure physiopathology, Humans, Israel, Male, Middle Aged, Prospective Studies, Registries, Renal Dialysis, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic physiopathology, Renal Insufficiency, Chronic therapy, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Electric Countershock instrumentation, Glomerular Filtration Rate, Heart Failure mortality, Heart Failure therapy, Kidney physiopathology, Renal Insufficiency, Chronic mortality
- Abstract
Aims: Heart failure patients with advanced chronic kidney disease (CKD) may experience an increased rate of non-arrhythmic mortality due to associated comorbidities. We aimed to evaluate the risk of mortality without appropriate implantable cardioverter-defibrillator (ICD) shocks in this high-risk population., Methods and Results: The study population comprised 3542 patients who received an ICD, were enrolled, and prospectively followed-up in the Israeli ICD registry. Study patients were categorized into two groups: those with advanced CKD [defined by a glomerular filtration rate of <30 mL/min/1.73 m2 or being on dialysis at time of implantation (n = 197)], and those without advanced CKD (n = 3344). The primary endpoint was the risk of death without receiving appropriate ICD shock. Kaplan-Meier survival analysis showed that at 5 years of follow-up the rates of death without prior ICD shock were significantly higher in the advanced kidney disease group (46%) compared with the non-advanced CKD group (19%; log-rank P-value <0.001). Consistently, multivariate analysis showed that the risk of death without receiving appropriate ICD shock therapy at 5 years was 2.5-fold (P < 0.001) higher among advanced CKD patients. In contrast, the rate of appropriate ICD shock therapy at 5 years among advanced CKD patients was only 9%, with a very high mortality rate (63%) within 3.5 years subsequent to shock therapy., Conclusion: Nearly one-half of ICD with advanced CKD die within 5 years without receiving an appropriate ICD shock. These findings stress the importance of appropriate patient selection for primary ICD implantation in this high-risk population., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.)
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- 2019
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5. Arrhythmic Events in Brugada Syndrome: A Nationwide Israeli Survey of the Clinical Characteristics, Treatment; and Long-Term Follow-up (ISRABRU-VF).
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Leshem E, Rahkovich M, Mazo A, Suleiman M, Blich M, Laish-Farkash A, Konstantino Y, Fogelman R, Strasberg B, Geist M, Chetboun I, Swissa M, Ilan M, Glick A, Michowitz Y, Rosso R, Glikson M, and Belhassen B
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- Adolescent, Adult, Aged, Aged, 80 and over, Anti-Arrhythmia Agents therapeutic use, Arrhythmias, Cardiac therapy, Brugada Syndrome therapy, Cohort Studies, Comorbidity, Electrocardiography methods, Female, Follow-Up Studies, Humans, Israel epidemiology, Male, Middle Aged, Quinidine therapeutic use, Young Adult, Arrhythmias, Cardiac epidemiology, Arrhythmias, Cardiac physiopathology, Brugada Syndrome epidemiology, Brugada Syndrome physiopathology, Defibrillators, Implantable
- Abstract
Background: Limited information exists about detailed clinical characteristics and management of the small subset of Brugada syndrome (BrS) patients who had an arrhythmic event (AE)., Objectives: To conduct the first nationwide survey focused on BrS patients with documented AE., Methods: Israeli electrophysiology units participated if they had treated BrS patients who had cardiac arrest (CA) (lethal/aborted; group 1) or experienced appropriate therapy for tachyarrhythmias after prophylactic implantable cardioverter defibrillator (ICD) implantation (group 2)., Results: The cohort comprised 31 patients: 25 in group 1, 6 in group 2. Group 1: 96% male, mean CA age 38 years (range 13-84). Nine patients (36%) presented with arrhythmic storm and three had a lethal outcome; 17 (68%) had spontaneous type 1 Brugada electrocardiography (ECG). An electrophysiology study (EPS) was performed on 11 patients with inducible ventricular fibrillation (VF) in 10, which was prevented by quinidine in 9/10 patients. During follow-up (143 ± 119 months) eight patients experienced appropriate shocks, none while on quinidine. Group 2: all male, age 30-53 years; 4/6 patients had familial history of sudden death age < 50 years. Five patients had spontaneous type 1 Brugada ECG and four were asymptomatic at ICD implantation. EPS was performed in four patients with inducible VF in three. During long-term follow-up, five patients received ≥ 1 appropriate shocks, one had ATP for sustained VT (none taking quinidine). No AE recurred in patients subsequently treated with quinidine., Conclusions: CA from BrS is apparently a rare occurrence on a national scale and no AE occurred in any patient treated with quinidine.
- Published
- 2018
6. Contemporary rates of appropriate shock therapy in patients who receive implantable device therapy in a real-world setting: From the Israeli ICD Registry.
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Sabbag A, Suleiman M, Laish-Farkash A, Samania N, Kazatsker M, Goldenberg I, Glikson M, and Beinart R
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- Aged, Cohort Studies, Death, Sudden, Cardiac epidemiology, Female, Heart Failure complications, Hospitalization, Humans, Israel epidemiology, Kaplan-Meier Estimate, Male, Middle Aged, Tachycardia complications, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Electric Countershock statistics & numerical data, Registries
- Abstract
Background: Implantable cardioverter-defibrillators (ICDs) have become the mainstay of preventive measures for sudden cardiac death (SCD). However, there are limited data on rates of appropriate life-saving ICD shock therapies in contemporary real-life settings., Objective: The purpose of the study was to evaluate the rate of appropriate life-saving ICD shock therapies in a contemporary registry., Methods: The Israeli ICD Registry includes all implants and other ICD operative procedures nationwide. The present study comprises 2349 consecutive cases who were enrolled in the Registry and prospectively followed up for information regarding survival, hospitalizations, and ICD therapies since 2010., Results: Kaplan-Meier survival analysis showed that the rate of appropriate ICD shock therapy at 30-month follow-up was 2.6% among patients who received an ICD for primary prevention compared with 7.4% among those who received a device for secondary prevention (log-rank P < .001). Rates of appropriate ICD shocks among primary prevention patients were 1.1% at 1-year of follow-up and 2.6% at 30 months, whereas the corresponding rates in the secondary prevention group were 3.8% at 1 year and 7.4% at 30 months (log-rank P < .001). A total of 253 patients (4.8%) died during follow-up, 65% of noncardiac causes., Conclusion: Rates of life-saving appropriate ICD shock therapies among patients implanted with a defibrillator for the primary prevention of SCD in a contemporary real-world setting are lower than reported previously. These findings suggest a need for improved risk stratification and patient selection in this population., (Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
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7. Outcome of Patients with Advanced Heart Failure Who Receive Device-Based Therapy for Primary Prevention of Sudden Cardiac Death: Insights from the Israeli ICD Registry.
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Suleiman M, Goldenberg I, Samniah N, Rosso R, Marai I, Pekar A, Khalameizer V, Militianu A, and Glikson M
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- Aged, Female, Humans, Israel, Male, Middle Aged, Prospective Studies, Registries, Treatment Outcome, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Heart Failure complications, Heart Failure therapy, Primary Prevention
- Abstract
Background: Randomized clinical trials have shown conflicting data on the benefit of implantable cardioverter defibrillator (ICD) for primary prevention of sudden cardiac death in patients with more advanced heart failure (HF) symptoms. Using the Israeli ICD Registry data, we sought to examine the effect of HF functional class on the outcome of patients who receive device therapy in a real-world setting., Methods: The association between HF functional class (categorized as baseline New York Heart Association [NYHA] functional class I and II in [61%] vs class III and IV in [39%]) and clinical outcomes was assessed among 913 patients who received an ICD (n = 514) or a cardiac resynchronization therapy with a defibrillator (CRT-D; n = 399) device and were prospectively followed in the Israeli ICD Registry between July 2011 and June 2013., Results: The risk associated with advanced HF functional class was significantly different in ICD and CRT-D recipients. In the former group, patients with NYHA classes III and IV experienced >3-fold increased risk of HF or death (hazard ratio [HR] = 3.28; P < 0.001), whereas among CRT-D recipients the risk was similar between patients with NYHA III/IV and those with less advanced HF symptoms (HR = 0.97 [95% confidence interval (CI) 0.54-1.78]; P = 0.42; P value for NYHA functional class by device type interaction = 0.002). The risk for ventricular arrhythmia (VA) was significantly lower among patients with more advanced NYHA functional class, regardless of device type (overall HR = 0.52; 95% CI 0.33-0.91; P = 0.04)., Conclusion: Our findings suggest that patients with less advanced HF symptoms experience a greater risk for VA and the development of HF is attenuated in CRT-D recipients with more advanced NYHA functional class., (© 2015 Wiley Periodicals, Inc.)
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- 2015
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8. Ethnic differences among implantable cardioverter defibrillators recipients in Israel.
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Sabbag A, Suleiman M, Glick A, Medina A, Golovchiner G, Steiner H, Arad M, Goldenberg I, Glikson M, and Beinart R
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- Aged, Cause of Death trends, Death, Sudden, Cardiac ethnology, Female, Follow-Up Studies, Heart Failure ethnology, Humans, Israel epidemiology, Male, Middle Aged, Prevalence, Prognosis, Prospective Studies, Survival Rate trends, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Ethnicity, Heart Failure therapy
- Abstract
Heart failure is an increasingly common condition arising from a variety of different pathophysiological processes. Little is known about the unique features of Israeli Arabs who present with heart failure and who undergo cardiac device implantation. The study population comprised of 4,671 patients who were enrolled in the national Israeli Implantable Cardioverter Defibrillator registry. We compared demographic, clinical, and echocardiographic characteristics; device-related indications; and outcomes between Israeli Arabs (n = 733) and Jews (n = 3,938), who were enrolled in the registry from July 2010 through December 2013. Israeli Arabs constituted 15.7% of the study population. They were younger at presentation compared with Jews (57 ± 15 vs 66 ± 12 years, respectively; p <0.001), with a greater burden of co-morbidities, including diabetes mellitus and chronic obstructive lung disease and smoking. In addition, Arab patients had a greater frequency of non-ischemic cardiomyopathy (40.2% vs 24.6%, respectively; p <0.001), which was associated with a greater frequency of familial history of sudden cardiac death. During 15 ± 9 month follow-up, the mortality rates and appropriate device therapy were similar in both ethnic groups. In conclusion, Israeli Arab patients implanted with implantable cardioverter defibrillators display unique clinical features with greater prevalence of non-ischemic cardiomyopathy characterized by an early-onset and rapid deterioration., (Copyright © 2015 Elsevier Inc. All rights reserved.)
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- 2015
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9. Renal dysfunction and clinical outcomes of patients undergoing ICD and CRTD implantation: data from the Israeli ICD registry.
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Eisen A, Suleiman M, Strasberg B, Sela R, Rosenheck S, Freedberg NA, Geist M, Ben-Zvi S, Goldenberg I, Glikson M, and Haim M
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- Aged, Female, Humans, Israel, Male, Middle Aged, Postoperative Complications epidemiology, Prospective Studies, Registries, Retrospective Studies, Treatment Outcome, Cardiac Resynchronization Therapy adverse effects, Defibrillators, Implantable adverse effects, Kidney physiopathology, Postoperative Complications etiology
- Abstract
Background: Implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy (CRT) reduce mortality in patients with heart failure (HF) and left ventricular dysfunction. However, their efficacy in patients with chronic kidney disease (CKD) is controversial., Objective: We examined the association between renal dysfunction and clinical outcomes in patients undergoing ICD and CRT defibrillator (CRTD) implantation., Methods: Data were collected from the Israeli ICD registry. Estimated glomerular filtration rate (eGFR) at implantation was assessed using the modification of diet in renal disease formula. Primary outcome was all-cause mortality. Secondary outcomes included the composite endpoints of death or HF and death or ventricular arrhythmias (ventricular tachycardia/ventricular fibrillation [VT/VF]); any hospitalizations; first appropriate and inappropriate ICD therapy., Results: During the study period (July 2010-November 2012), 2,811 patients were implanted with ICD or CRTD. One-year follow-up data were available for 730 ICD patients and 453 CRTD patients. Patients with eGFR < 30 mL/minute/1.73 m(2) (n = 54, 4.6%) were older, had a higher prevalence of diabetes, hypertension, or ischemic heart disease. eGFR <30 mL/minute/1.73 m(2) was associated with increased mortality risk in ICD (HR 5.4; 95% CI 1.5-19.2), but not in CRTD patients (HR 0.9; 95% CI 0.1-7.5). Renal dysfunction was associated with the composite endpoints of death or HF and death or VT/VF in ICD, but not in CRTD patients. Mean eGFR during follow-up decreased by 8.0 ± 4.3 mL/minute/1.73 m(2) in ICD patients (P = 0.06) and by 1.8 ± 1.3 mL/minute/1.73 m(2) in patients with CRTD (P = 0.2)., Conclusion: Based on this retrospective analysis, CKD is associated with adverse prognosis after ICD implantation, but not after CRTD implantation. GFR decreased in patients with ICD, but not in CRTD patients., (© 2014 Wiley Periodicals, Inc.)
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- 2014
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10. Sex differences in implantable cardioverter-defibrillator implantation indications and outcomes: lessons from the Nationwide Israeli-ICD Registry.
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Amit G, Suleiman M, Konstantino Y, Luria D, Kazatsker M, Chetboun I, Haim M, Gavrielov-Yusim N, Goldenberg I, and Glikson M
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- Aged, Arrhythmias, Cardiac complications, Arrhythmias, Cardiac diagnosis, Arrhythmias, Cardiac mortality, Chi-Square Distribution, Death, Sudden, Cardiac etiology, Electric Countershock adverse effects, Electric Countershock mortality, Female, Heart Failure etiology, Heart Failure therapy, Hospitalization, Humans, Israel, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Proportional Hazards Models, Prospective Studies, Registries, Retreatment, Risk Factors, Sex Factors, Time Factors, Treatment Outcome, Arrhythmias, Cardiac therapy, Cardiac Resynchronization Therapy adverse effects, Cardiac Resynchronization Therapy mortality, Cardiac Resynchronization Therapy Devices, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Electric Countershock instrumentation, Health Status Disparities, Healthcare Disparities, Primary Prevention instrumentation, Secondary Prevention instrumentation
- Abstract
Aims: Implantable cardioverter-defibrillators (ICDs) improve survival in certain high arrhythmic risk populations. However, there are sex differences regarding both the utilization and the benefit of these devices. Using a prospective national ICD registry, we aim to compare the indications for ICD implantation as well as outcomes in implanted women vs. men., Methods and Results: All subjects implanted with an ICD or cardiac resynchronization therapy with a defibrillator (CRTD) in Israel between July 2010 and February 2013 were included. A total of 3544 subjects constructed the baseline cohort, of whom 615 (17%) were women. Women had the same age (64 years) and rate of secondary prevention indication (26%) as men. However, women were more likely than men to have significant heart failure symptoms (52 vs. 45%), QRS > 120 ms (41 vs. 36%), and a higher rate of non-ischaemic cardiomyopathy (54 vs. 21%, all P values <0.05). Using multivariate analysis, women were more likely to undergo CRTD implantation (odds ratio = 1.8, P < 0.01). Follow-up data were available for 1518 subjects with a mean follow-up of 12 months. During follow-up, there were no significant differences among genders in the rate of any single or the combined outcomes of appropriate device therapies, heart failure admissions, or death. First-year re-intervention rate was double among women (5.6 vs. 3.0%, P < 0.01)., Conclusion: In real-world setting, women implanted with an ICD differ significantly from men in their baseline characteristics and in the use of CRTD devices. These, however, did not translate into outcome differences., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.)
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- 2014
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11. Role of defibrillation threshold testing during implantable cardioverter-defibrillator placement: data from the Israeli ICD Registry.
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Arnson Y, Suleiman M, Glikson M, Sela R, Geist M, Amit G, Schliamser JE, Goldenberg I, Ben-Zvi S, Orvin K, Rosenheck S, Adam Freedberg N, Strasberg B, and Haim M
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- Death, Sudden, Cardiac epidemiology, Electrocardiography, Female, Follow-Up Studies, Humans, Incidence, Israel epidemiology, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Survival Rate trends, Time Factors, Ventricular Fibrillation physiopathology, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Registries, Ventricular Fibrillation therapy
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Background: Defibrillation threshold (DFT) testing during placement of an implantable cardioverter-defibrillator (ICD) has been considered mandatory. Accumulating data suggest a more limited role for DFT., Objective: The purpose of this study was to compare the outcome of ICD recipients who underwent DFT testing compared with those who did not., Methods: In this prospective cohort analysis of patients who received an ICD between July 2010 and March 2013, we compared patients who underwent DFT testing and those who did not. Primary end-points were death and malignant ventricular arrhythmias. Secondary end-points included the composite end-points and inappropriate ICD discharges., Results: Of the 3596 patients in the registry, 614 patients (17%) underwent DFT testing during ICD placement vs 2982 (83%) who did not. Variables associated with ICD testing were implantation for secondary prevention (relative risk [RR] 1.87), prior ventricular arrhythmias (RR 1.81), use of antiarrhythmic medication (RR 1.59), and sinus rhythm (RR 2.05). Factors predisposing against testing were cardiac resynchronization therapy defibrillator implantation (RR 0.56) and concomitant diuretic use (RR 0.71). ICD testing was not associated with 1-year mortality (5.3% vs 5.1%, P = .74), delivery of appropriate shocks (8.6% vs 5.6%, P = .16), combined outcomes of ventricular arrhythmias and death (12.9% vs 11.3%, P = .45), or inappropriate ICD discharges (3.9% vs 2.1%, P = .2) compared to no DFT testing., Conclusion: No significant differences in the incidence of mortality, malignant ventricular arrhythmias, or inappropriate ICD discharges were observed between patients who underwent DFT testing compared to those who did not. Our results may support avoiding DFT testing during ICD placement, but this requires confirmation by additional prospective studies., (Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
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- 2014
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12. Clinical characteristics and outcomes of elderly patients treated with an implantable cardioverter-defibrillator or cardiac resynchronization therapy in a real-world setting: data from the Israeli ICD Registry.
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Suleiman M, Goldenberg I, Haim M, Schliamser JE, Boulos M, Ilan M, Swissa M, Gavrielov-Yusim N, Fuchs T, Amit G, and Glikson M
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- Aged, Comorbidity, Female, Heart Diseases epidemiology, Humans, Israel epidemiology, Male, Middle Aged, Postoperative Complications epidemiology, Prospective Studies, Registries, Risk Factors, Treatment Outcome, Cardiac Resynchronization Therapy, Defibrillators, Implantable, Heart Diseases therapy
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Background: Elderly patients are underrepresented in clinical trials of device therapy., Objective: To provide real-world data regarding outcomes associated with device-based therapy in a large cohort of elderly patients enrolled in the Israeli ICD Registry., Methods: Between July 2010 and June 2012, a total of 2807 consecutive patients undergoing implanted cardioverter-defibrillator/cardiac resynchronization therapy-defibrillator (ICD/CRT-D) implantation were prospectively enrolled in the Israeli ICD Registry. For the present analysis, patients were categorized into 3 age groups: ≤60 years (n = 1378 [49%]), 61-75 years (n = 863 [31%]), and >75 years (n = 566 [20%])., Results: Elderly patients (>75 years of age) had more comorbid conditions and were more likely to undergo CRT-D implantation (all P < .01). However, the rate of device-related complications associated with surgical reinterventions at 1 year was <3% regardless of age (P = .70 for the comparison among the 3 age groups). Multivariate analysis showed that the risk of heart failure or death and of appropriate ICD therapy for ventricular arrhythmias was significantly increased with increasing age among patients who received an ICD. In contrast, the age-related increase in the risk of all end points was attenuated among patients who received CRT-D devices (all P values for age-by-device-type interactions are <.05)., Conclusions: In a real-world scenario, elderly patients (>75 years of age) comprise approximately 20% of the ICD/CRT-D recipients and experience a device reintervention rate similar to that of their younger counterparts. Our data suggest that the association between advanced age and adverse clinical outcomes is attenuated in elderly patients implanted with CRT-D devices., (Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
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- 2014
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13. Importance of ventricular tachycardia storms not terminated by implantable cardioverter defibrillators shocks in patients with CASQ2 associated catecholaminergic polymorphic ventricular tachycardia.
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Marai I, Khoury A, Suleiman M, Gepstein L, Blich M, Lorber A, and Boulos M
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- Adolescent, Calsequestrin metabolism, Cause of Death trends, Child, Child, Preschool, Death, Sudden, Cardiac epidemiology, Defibrillators, Implantable, Electrocardiography, Female, Follow-Up Studies, Genotype, Humans, Incidence, Infant, Infant, Newborn, Israel epidemiology, Male, Prognosis, Tachycardia, Ventricular physiopathology, Tachycardia, Ventricular therapy, Time Factors, Young Adult, Calsequestrin genetics, DNA genetics, Death, Sudden, Cardiac prevention & control, Mutation, Missense, Tachycardia, Ventricular genetics
- Abstract
In this study, the clinical and implantable cardioverter-defibrillator (ICD)-related follow-up of patients with catecholaminergic polymorphic ventricular tachycardia (CPVT) with homogenous missense mutations in CASQ2 was summarized. Patients were followed in a pediatric cardiology clinic and an ICD clinic. All patients were treated with high-dose β blockers. ICDs were recommended for patients who remained symptomatic despite medical treatment. Twenty-seven patients were followed for 1 to 15 years (median 9). Twenty patients (74%) were symptomatic at diagnosis; 13 (65%) remained symptomatic after treatment with high-dose β blockers and thus were advised to receive ICDs. Eight of these patients refused ICDs, and eventually 6 (75%) died suddenly. Four of the 5 patients who received ICDs had ventricular tachycardia storms treated but not terminated by recurrent ICD shocks. These ventricular tachycardia storms (2 episodes in 2 patients and 1 episode in 2 patient) terminated spontaneously after finishing the programmed ICD shocks, without degeneration to ventricular fibrillation. None of the patients who received ICDs died. In conclusion, patients with CASQ2-associated CPVT should be recommended to receive ICDs to prevent sudden death when medical therapy is not effective. These patients may have recurrent ventricular tachycardia storms treated but not terminated by recurrent ICD shocks, without degeneration to ventricular fibrillation., (Copyright © 2012 Elsevier Inc. All rights reserved.)
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- 2012
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14. Usefulness of changes in fasting glucose during hospitalization to predict long-term mortality in patients with acute myocardial infarction.
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Aronson D, Hammerman H, Suleiman M, and Markiewicz W
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- Female, Follow-Up Studies, Humans, Hyperglycemia etiology, Israel epidemiology, Male, Middle Aged, Myocardial Infarction blood, Myocardial Infarction complications, Prognosis, Proportional Hazards Models, Retrospective Studies, Risk Factors, Survival Rate trends, Time Factors, Blood Glucose metabolism, Fasting blood, Hospitalization, Hyperglycemia blood, Myocardial Infarction mortality
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Stress hyperglycemia is a complex phenomenon that incorporates the cumulative effects of multiple factors. Rapid changes in blood glucose may reflect neurohormonal and homodynamic events that affect patient outcome. We prospectively studied the relation between changes in fasting glucose (FG) during a hospital course and long-term mortality in 1,467 nondiabetic patients with acute myocardial infarction. FG was obtained at admission and later during the hospital course and classified at each time point as normal (<100 mg/dl), impaired (100 to 125 mg/dl), or diabetic range (>or=126 mg/dl). The relation between measurements of FG and mortality (median follow-up 30 months) was assessed using Cox models. FG classification improved in 426 (29.0%) and worsened in 248 patients (16.9%) during hospitalization. Mean FG was a better predictor of mortality than baseline or final FG levels alone (C-index 0.670, 0.656, and 0.645, respectively). Changes in FG during hospitalization were strongly associated with changes in mortality risk. Compared to patients with persistent normal FG, the adjusted hazard ratio (HR) for mortality was 2.6 (95% confidence interval [CI] 1.0 to 7.2) for patients in whom FG increased to the diabetic range; the HR was 6.3 (95% CI 4.0 to 10.4) in patients with persistent FG in the diabetic range but decreased substantially when FG normalized during hospitalization (HR 2.7, 95% CI 1.3 to 5.1). In conclusion, persistent increase of FG during hospitalization for acute myocardial infarction has greater prognostic effect than baseline FG. Changes in FG during hospitalization are simple and sensitive indicators of dynamic changes in risk.
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- 2009
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15. Fasting glucose in acute myocardial infarction: incremental value for long-term mortality and relationship with left ventricular systolic function.
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Aronson D, Hammerman H, Kapeliovich MR, Suleiman A, Agmon Y, Beyar R, Markiewicz W, and Suleiman M
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- Adult, Aged, Diabetic Angiopathies mortality, Fasting, Female, Follow-Up Studies, Humans, Israel, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Retrospective Studies, Survival Analysis, Systole, Time Factors, Blood Glucose analysis, Diabetic Angiopathies blood, Myocardial Infarction blood, Myocardial Infarction mortality, Ventricular Dysfunction, Left blood, Ventricular Function, Left
- Abstract
Objective: Elevation of blood glucose is a common metabolic disorder among patients with acute myocardial infarction (AMI) and is associated with adverse prognosis. However, few data are available concerning the long-term prognostic value of elevated fasting glucose during the acute phase of infarction., Research Design and Methods: We prospectively studied the relationship between fasting glucose and long-term mortality in patients with AMI. Fasting glucose was determined after an >/=8 h fast within 24 h of admission. The median duration of follow-up was 24 months (range 6-48). All multivariable Cox models were adjusted for the Global Registry of Acute Coronary Events (GRACE) risk score., Results: In nondiabetic patients (n = 1,101), compared with patients with normal fasting glucose (<100 mg/dl), the adjusted hazard ratio for mortality progressively increased with higher tertiles of elevated fasting glucose (first tertile 1.5 [95% CI 0.8-2.9], P = 0.19; second tertile 3.2 [1.9-5.5], P < 0.0001; third tertile 5.7 [3.5-9.3], P < 0.0001). The c statistic of the model containing the GRACE risk score increased when fasting glucose data were added (0.8 +/- 0.02-0.85 +/- 0.02, P = 0.004). Fasting glucose remained an independent predictor of mortality after further adjustment for ejection fraction. Elevated fasting glucose did not predict mortality in patients with diabetes (n = 462)., Conclusions: Fasting glucose is a simple robust tool for predicting long-term mortality in nondiabetic patients with AMI. Fasting glucose provides incremental prognostic information when added to the GRACE risk score and left ventricular ejection fraction. Fasting glucose is not a useful prognostic marker in patients with diabetes.
- Published
- 2007
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