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13 results on '"Dai-Pp Investigators"'

1. Early mortality after implantable cardioverter defibrillator: Incidence and associated factors

Author

Marie-Cécile Perier, Nicolas Sadoul, Pierre Bordachar, Dai-Pp Investigators, Didier Klug, Rui Providência, Eloi Marijon, V. Algalarrondo, Olivier Piot, Jean-Claude Deharo, Daniel Gras, Rodrigue Garcia, Dominique Babuty, Laurent Fauchier, Serge Boveda, Pascal Defaye, Kumar Narayanan, Christophe Leclercq, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Clinique Pasteur, Clinique Pasteur [Toulouse], Hôpital Michallon, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université d'Hyderabad, Bases moléculaires de la réponse aux xénobiotiques (U775 (IFR95)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Pontchaillou [Rennes], Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Hôpital privé du Confluent [Nantes], Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Cardiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Centre Hospitalier de Saint-Denis [Ile-de-France], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Diderot, Sorbonne Paris Cité, Paris, France, Université Paris Diderot - Paris 7 (UPD7), Arrhythmia Group of the French Society of Cardiology, Clinical sciences, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), and CCSD, Accord Elsevier

Subjects
Male, Death, Sudden, Cardiac/prevention & control, Multivariate analysis, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Guideline, France/epidemiology, PREDICT, Sudden cardiac death, Prosthesis Implantation/methods, 0302 clinical medicine, Cause of Death, Atrial Fibrillation, Implantable cardioverter defibrillator, risk factors, Medicine, 030212 general & internal medicine, OUTCOMES, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Incidence (epidemiology), Defibrillators, Implantable/adverse effects, Hazard ratio, Age Factors, risk assessment, Atrial fibrillation, Middle Aged, Prognosis, Implantable cardioverter-defibrillator, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Defibrillators, Implantable, 3. Good health, [SDV] Life Sciences [q-bio], Female, France, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Electric Countershock, Heart failure, VALIDATION, Prosthesis Implantation, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Electric Countershock/instrumentation, MANAGEMENT, Humans, Mortality, business.industry, Prevention, Tachycardia, Ventricular/mortality, medicine.disease, RISK SCORE, Survival Analysis, EARLY MORTALITY, RECIPIENTS, Death, Sudden, Cardiac, Atrial Fibrillation/epidemiology, Tachycardia, Ventricular, Observational study, Heart Failure/epidemiology, business, PRIMARY PREVENTION, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Background: According to guidelines, implantable cardioverter defibrillator (ICD) candidates must have a "reasonable expectation of survival with a good functional status >1 year". Identifying risk for early mortality in ICD candidates could be challenging. We aimed to identify factors associated with a =1-year survival among patients implanted with ICDs.Methods: The DAI-PP program was a multicenter, observational French study that included all patients who received a primary prevention ICD in the 2002-2012 period. Characteristics of patients who survived = III), and atrial fibrillation were significantly associatedwith

Published
2020

2. Usefulness of a clinical risk score to predict the response to cardiac resynchronization therapy

Author

Jan Steffel, Rudolph Duehmke, Olivier Piot, Pier D. Lambiase, Jean Claude Deharo, Anthony Chow, Serge Boveda, Rui Providência, Eloi Marijon, Nikolaos Papageorgiou, Didier Klug, Christophe Leclercq, Richard Ang, Christian Reitan, Nicolas Sadoul, Alexander Breitenstein, Pierre Bordachar, S.C. Agarwal, Oliver R. Segal, Laurent Fauchier, Pascal Defaye, Tardu Oezkartal, Stephan Winnik, Dai-Pp Investigators, Daniel Gras, Sérgio Barra, Rasmus Borgquist, University of Zurich, and Providencia, Rui

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Cardiac resynchronization therapy, Renal function, 610 Medicine & health, 030204 cardiovascular system & hematology, 2705 Cardiology and Cardiovascular Medicine, Cardiac Resynchronization Therapy, 03 medical and health sciences, QRS complex, 0302 clinical medicine, Predictive Value of Tests, Risk Factors, Internal medicine, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, Aged, Heart Failure, Framingham Risk Score, Ejection fraction, business.industry, Atrial fibrillation, Middle Aged, medicine.disease, Treatment Outcome, Heart failure, 10209 Clinic for Cardiology, cardiovascular system, Cardiology, Female, Implant, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, Glomerular Filtration Rate
Abstract

Almost 1/3 of heart failure patients fail to respond to cardiac resynchronization therapy (CRT). A simple clinical score to predict who these patients are at the moment of referral or at time of implant may be of importance for early optimization of their management.Observational study. A risk score was derived from factors associated to CRT response. The derivation cohort was composed of 1301 patients implanted with a CRT defibrillator in a multi-center French cohort-study. External validation of this score and assessment of its association with CRT response and all-cause mortality and/or heart transplant was performed in 1959 CRT patients implanted in 4 high-volume European centers.Independent predictors of CRT response in the derivation cohort were: female gender (OR = 2.08, 95% CI 1.26-3.45), NYHA class ≤ III (OR = 2.71, 95% CI 1.63-4.52), left ventricular ejection fraction ≥ 25% (OR = 1.75, 95% CI 1.27-2.41), QRS duration ≥ 150 ms (OR = 1.70, 95% CI 1.25-2.30) and estimated glomerular filtration rate ≥ 60 mL/min (OR = 2.01, 95% CI 1.48-2.72). Each was assigned 1 point. External validation showed good calibration (Hosmer-Lemeshow test-P = 0.95), accuracy (Brier score = 0.19) and discrimination (c-statistic = 0.67), with CRT response increasing progressively from 37.5% in patients with a score of 0 to 91.9% among those with score of 5 (Gamma for trend = 0.44, P 0.001). Similar results were observed regarding all-cause mortality or heart transplant.The ScREEN score (Sex category, Renal function, ECG/QRS width, Ejection fraction and NYHA class) is composed of widely validated, easy to obtain predictors of CRT response, and predicts CRT response and overall mortality. It should be helpful in facilitating early consideration of alternative therapies for predicted non-responders to CRT therapy.

Published
2018

3. Temporal Trends Over a Decade of Defibrillator Therapy for Primary Prevention in Community Practice

Author

Frankie Beganton, Nicolas Sadoul, Serge Boveda, Sophie Jacob, Jean-Claude Deharo, Pascal Defaye, Vincent Algalarrondo, Dominique Babuty, Pierre Bordachar, Eloi Marijon, Daniel Gras, Kumar Narayanan, Olivier Piot, Dai-Pp Investigators, Didier Klug, Laurent Fauchier, Christophe Leclercq, Marie-Cécile Perier, A. Bouzeman, and Rui Providência

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Mean age, 030204 cardiovascular system & hematology, Implantable cardioverter-defibrillator, medicine.disease, Icd therapy, 3. Good health, Sudden cardiac death, 03 medical and health sciences, 0302 clinical medicine, Nonischemic cardiomyopathy, Physiology (medical), Internal medicine, Primary prevention, medicine, Cardiology, Community practice, 030212 general & internal medicine, Implant, Cardiology and Cardiovascular Medicine, business
Abstract

Temporal Trends Over a Decade of Defibrillator TherapyBackground Technology and clinical practice surrounding the use of the primary prevention implantable cardioverter defibrillator (ICD) are in a state of constant evolution. The purpose of the study was to test the hypothesis of significant temporal trends in characteristics and outcomes over a decade of ICD therapy. Methods Between 2002 and 2012, 5,539 consecutive patients (age 62.5 ± 11 years, 84.9% male), with ischemic or nonischemic cardiomyopathy, implanted with a primary prevention ICD from 12 centers in France were included. Information on characteristics and outcomes (including causes of death) were evaluated over a median follow-up of 994 days (466-1,667). Results In addition to a shift in the type of devices implanted with a significant increase in cardiac resynchronization therapy-defibrillator (CRT-D) over time (43.6 to 60.4%, P = 0.0001), an increase in mean age (from 61.5 ± 11.6 to 63.2 ± 10.9 years, P = 0.0016), proportion of nonischemic cardiomyopathy (31.0 to 44.7%, P 30 days after implant) complications significantly increased (4.6 to 7.6%, P = 0.003). Conclusion Our findings demonstrate significant changes in patterns of use and outcomes in primary prevention ICD over the last decade with reductions in mortality and appropriate therapies, counterbalanced by an increase in complications.

Published
2017

4. Prophylactic implantable cardioverter defibrillators for primary prevention: From implantation to heart transplantation

Author

Rodrigue Garcia, Pierre Bordachar, Nicolas Combes, Dominique Babuty, Eloi Marijon, Serge Boveda, Daniel Gras, Marie-Cécile Bories, Nicolas Sadoul, Pascal Defaye, Laurent Fauchier, Christophe Leclercq, Dai-Pp Investigators, Vincent Algalarrondo, Kumar Narayanan, Marie-Cécile Perier, Jean-Claude Deharo, Romain Perault, Didier Klug, Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Clinique Pasteur [Toulouse], Cardiac Stimulation and Rhythmology, CHU Grenoble, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Cardiologie B, and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)

Subjects
Male, Time Factors, medicine.medical_treatment, 030204 cardiovascular system & hematology, Heart transplantation, Sudden cardiac death, [SHS]Humanities and Social Sciences, Transplantation cardiaque, 0302 clinical medicine, Risk Factors, Interquartile range, Implantable cardioverter defibrillator, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, education.field_of_study, Ejection fraction, Sudden death, Incidence, Défibrillateur automatique implantable, General Medicine, Middle Aged, Implantable cardioverter-defibrillator, Defibrillators, Implantable, Primary Prevention, Treatment Outcome, Cardiology, Female, France, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, Population, Electric Countershock, Cardiac resynchronization therapy, Heart failure, Mortalité, 03 medical and health sciences, Internal medicine, medicine, Humans, Mortality, education, Aged, business.industry, Recovery of Function, medicine.disease, Insuffisance cardiaque, Mort subite, Death, Sudden, Cardiac, business
Abstract

The frequency, characteristics and outcomes of primary prevention implantable cardioverter defibrillator (ICD) recipients who eventually undergo heart transplantation (HT) during follow-up have not been well described.In a cohort of patients with heart failure implanted with an ICD for primary prevention of sudden cardiac death, to identify those at high risk of subsequent HT and evaluate ICD usefulness.Between 2002 and 2012, 5539 patients received a primary prevention ICD across 12 centers, and were enrolled in the DAI-PP programme, including 5427 with full HT information available.During a median follow-up of 1024 days (interquartile range 484-1702 days), 176 (3.2%) patients underwent HT. Median duration between ICD implantation and HT was 484 days (IQR 169-1117 days). Among those aged≤65 years (theoretical age limit for HT registration in France), the overall incidence per 1000 person-years was 18.03 (95% confidence interval [CI]: 15.32-20.74). Left ventricular ejection fraction25% (hazard ratio [HR]: 3.43, 95% CI: 2.34-5.04; P0.0001), younger age (HR: 0.95, 95% CI: 0.93-0.96; P0.0001), New York Heart Association (NYHA) class III-IV (HR: 2.67, 95% CI: 1.79-4.00; P0.0001) and no cardiac resynchronization therapy (HR: 2.09, 95% CI: 1.39-3.14; P=0.0004) were independently associated with HT. Patients with these three characteristics (excluding age) had a 1-year HT rate of 15.2%. Incidence of appropriate ICD therapies was 92.7 per 1000 person-years for patients who underwent HT versus 76.1 for those who did not (P=0.64).The overall incidence of HT in this primary prevention population was relatively high, especially among young patients with a very low ejection fraction, an advanced NYHA class and were unsuitable for cardiac resynchronization therapy (up to 15% annually). Patients awaiting HT experienced a significant rate of appropriate ICD therapies, reinforcing the importance of specific cardiac rhythm management in these patients.

Published
2018

5. Outcomes in Guideline-Based Versus Off-Guideline Primary Prevention Implantable Cardioverter-Defibrillator Recipients

Author

Christophe Leclercq, Nicolas Sadoul, Dai-Pp Investigators, Serge Boveda, William Escande, Jean-Claude Deharo, Marie-Cécile Perier, Pascal Defaye, Laurent Fauchier, Eloi Marijon, Olivier Piot, Clinique Pasteur et Groupe Rythmologie Stimulation Cardiaque/SFC, Clinique Pasteur [Toulouse], Cardiac Stimulation and Rhythmology, CHU Grenoble, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Electronique des Systèmes TEmps Réel (LESTER), Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre cardiologique du Nord (CCN), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'économie et de sociologie du travail (LEST), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), and Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
medicine.medical_specialty, Ejection fraction, business.industry, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Follow up studies, Guideline, 030204 cardiovascular system & hematology, Implantable cardioverter-defibrillator, medicine.disease, New york heart association, 3. Good health, Sudden cardiac death, 03 medical and health sciences, 0302 clinical medicine, Multicenter study, Primary prevention, Internal medicine, cardiovascular system, medicine, Cardiology, cardiovascular diseases, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business
Abstract

International audience; In the setting of primary prevention of sudden cardiac death, international guidelines (1) recommend an implantable cardioverter-defibrillator (ICD) for symptomatic patients (New York Heart Association [NYHA] functional class II or III) with altered left ventricular ejection fraction (LVEF) (#35%). Our objective was to compare outcomes among patients implanted with a primary prevention ICD according to whether the implantations were guideline-based or not. The DAI-PP (Primary Prevention ICD French Registry) (NCT01992458) enrolled all consecutive patients with ischemic or dilated cardiomyopathy implanted with a primary prevention ICD in 12 French centers between 2002 and 2012 (2). On-guideline patients met both basic criteria, namely, LVEF #35% and NYHA functional class II to III. Off-guideline patients did not meet at least 1 of the 2 criteria. We focused on candidates without an indication for cardiac resynchronization therapy. Vital status and causes of death were ascertained by review of hospital medical files or by communication with primary care physicians, and were corroborated with the French vital status database of the National Institute of Economic Statistics and the French Center on Medical Causes of Death. ICD programming was nonstandardized, although there was a broad consensus between centers (all except 1) concerning the use of high ventricular rates and usually 2 zones (typically ventricular tachycardia >180 beats/min, ventricular fibrillation >220 beats/ min). All data were analyzed using the SAS program version 9.4 (SAS Institute, Cary, North Carolina). Of a total of 5,539 patients enrolled in DAI-PP study, 2,538 were implanted with a single-or double-chamber ICD. Mean age was 60.2 AE 11.7 years, 1,694 (87.4%) were men, 1,379 (71.9%) had ischemic car-diomyopathy, mean LVEF was 28.2 AE 8.6%, and 853 (59.3%) had a QRS width

Published
2017

6. Dual- vs. single-chamber defibrillators for primary prevention of sudden cardiac death: long-term follow-up of the Défibrillateur Automatique Implantable—Prévention Primaire registry

Author

Frankie Beganton, Christophe Leclercq, Algalarrondo, Marie Cécile Perier, Eloi Marijon, Serge Boveda, Pierre Bordachar, Pascal Defaye, Dominique Babuty, Daniel Gras, Laurent Fauchier, Dai-Pp Investigators, Nicolas Sadoul, Kumar Narayanan, Jean-Claude Deharo, Didier Klug, Olivier Piot, Cardiac Stimulation and Rhythmology, CHU Grenoble, Clinique Pasteur et Groupe Rythmologie Stimulation Cardiaque/SFC, Clinique Pasteur [Toulouse], Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre cardiologique du Nord (CCN), Nouvelles Cliniques Nantaises, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hôpital Haut-Lévêque, Université Sciences et Technologies - Bordeaux 1-CHU Bordeaux [Bordeaux], Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Cardiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Laboratoire d'économie et de sociologie du travail (LEST), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CHU Bordeaux [Bordeaux]-Université Sciences et Technologies - Bordeaux 1, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Sciences et Technologies - Bordeaux 1 (UB)-CHU Bordeaux [Bordeaux], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Electronique et Systèmes de Télécommunications (LEST), Université de Brest (UBO)-Ecole Nationale Supérieure des Télécommunications de Bretagne-Centre National de la Recherche Scientifique (CNRS), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)

Subjects
Male, medicine.medical_specialty, Time Factors, Defibrillation, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Electric Countershock, 030204 cardiovascular system & hematology, Prosthesis Design, Implantable cardioverter-defibrillator, law.invention, Sudden cardiac death, 03 medical and health sciences, 0302 clinical medicine, law, Risk Factors, Physiology (medical), Internal medicine, Cause of Death, Clinical endpoint, Medicine, Humans, 030212 general & internal medicine, Registries, Inappropriate shock, Aged, Retrospective Studies, Sudden death prevention, business.industry, Surrogate endpoint, Single-chamber defibrillator, Incidence (epidemiology), Arrhythmias, Cardiac, Middle Aged, medicine.disease, 3. Good health, Defibrillators, Implantable, Prosthesis Failure, Clinical trial, Primary Prevention, Death, Sudden, Cardiac, Treatment Outcome, Artificial cardiac pacemaker, Female, France, Cardiology and Cardiovascular Medicine, business, Dual-chamber defibrillator
Abstract

International audience; AIMS: Implantable cardioverter defibrillators (ICDs) are an effective primary prevention of sudden cardiac death. We examined whether dual-chamber (DC) ICDs confer a greater benefit than single-chamber (SC) ICDs, and compared the long-term outcomes of recipients of each type of device implanted for primary prevention.AbstractAIMS:Implantable cardioverter defibrillators (ICDs) are an effective primary prevention of sudden cardiac death. We examined whether dual-chamber (DC) ICDs confer a greater benefit than single-chamber (SC) ICDs, and compared the long-term outcomes of recipients of each type of device implanted for primary prevention.METHODS AND RESULTS:Between 2002 and 2012, the DAI-PP registry consecutively enrolled 1258 SC- and 1280 DC-ICD recipients at 12 French medical centres. The devices were interrogated at 4- to 6-month intervals during outpatient visits, with a focus on the therapies delivered. The study endpoints were incidence of appropriate therapies, ICD-related morbidity, and deaths from all and from specific causes. The mean age of the SC- and DC-ICD recipients was 59 ± 12 and 62 ± 11 years, respectively (P< 0.0001). The distribution of genders, New York Heart Association functional classes and glomerular filtration rates, and the rates of ischaemic vs. dilated cardiomyopathies and of defibrillation tests at implant, were similar in both study groups. The rates of periprocedural complications were 12.1% in the DC- vs. 8.8% in the SC-ICD groups (P= 0.008). Over a mean follow-up of 3.1 ± 2.2 years, pulse generators were replaced in 21.9% of the DC- vs. 13.6% of the SC-ICD group (P< 0.0001). The proportions of patients treated with ≥1 appropriate therapies (24.7 vs. 23.8%) and ≥1 inappropriate shocks (8.4 vs. 7.8%), and all-cause mortality (12.4 vs. 13.2%) were similar in both groups.CONCLUSION:In this large registry of ICD implanted for primary prevention, DC-ICDs were associated with higher rates of peri-implant complications and generator replacements, whereas the survival and rates of inappropriate shocks were similar in both groups.CLINICAL TRIAL NUMBER:NCT#01992458.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions please email: journals.permissions@oup.com.

Published
2017

7. Implantable cardioverter-defibrillator therapy among patients with non-ischaemic vs. ischaemic cardiomyopathy for primary prevention of sudden cardiac death

Author

Christophe Leclercq, A. Bouzeman, Dominique Babuty, Frederic Treguer M.D., Pascal Defaye, Daniel Gras, Olivier Piot, Vincent Algalarrondo, Laurent Fauchier, Nicolas Sadoul, Dai-Pp Investigators, Nelly Amara, Denis Amet, Serge Boveda, Pierre Bordachar, Marie-Cécile Perier, Eloi Marijon, Didier Klug, Jean-Claude Deharo, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Clinique Pasteur [Toulouse], Cardiac Stimulation and Rhythmology, CHU Grenoble, Laboratoire des Écoulements Géophysiques et Industriels [Grenoble] (LEGI ), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Laboratoire d'Electronique des Systèmes TEmps Réel (LESTER), Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS), Service de Cardiologie A, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre cardiologique du Nord (CCN), Nouvelles Cliniques Nantaises, Hôpital Haut-Lévêque, Université Sciences et Technologies - Bordeaux 1 (UB)-CHU Bordeaux [Bordeaux], Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Service de Cardiologie B, Clinique Saintt Joseph, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), and Centre Hospitalier de Versailles André Mignot (CHV)

Subjects
Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Electric Countershock, Myocardial Ischemia, Cardiomyopathy, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, [SHS]Humanities and Social Sciences, Sudden cardiac death, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Cause of Death, Physiology (medical), Internal medicine, medicine, Humans, Sinus rhythm, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aged, Proportional Hazards Models, Retrospective Studies, Cause of death, Ejection fraction, Ischemic cardiomyopathy, business.industry, Hazard ratio, Middle Aged, medicine.disease, Implantable cardioverter-defibrillator, Defibrillators, Implantable, Primary Prevention, Death, Sudden, Cardiac, Treatment Outcome, Cardiology, Female, France, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business
Abstract

Aim The magnitude of benefit related to implantable cardioverter defibrillator (ICD) therapy for primary prevention of sudden cardiac death (SCD) in non-ischaemic cardiomyopathy (NICM) and ischaemic cardiomyopathy (ICM) has not been evaluated extensively in clinical practice. Methods and results Of the 5539 consecutive patients enrolled in the multicentre Defibrillateur Automatique Implantable-Prevention Primaire (DAI-PP) study (2002-12), 5485 patients (with information on underlying heart disease) were included in the present analysis: 2181 (39.8%) had NICM and 3304 (60.2%) had ICM. ICM patients were older (63.7 ±10.3 vs. 60.6 ± 12.2 years, P

Published
2017

8. Prediction of Nonarrhythmic Mortality in Primary Prevention Implantable Cardioverter-Defibrillator Patients With Ischemic and Nonischemic Cardiomyopathy

Author

Nicolas Sadoul, Pascal Defaye, Dai-Pp Investigators, Vincent Algalarrondo, Eloi Marijon, Marie-Cécile Perier, Olivier Piot, Didier Klug, Abdeslam Bouzeman, Jean-Claude Deharo, Pierre Bordachar, Christophe Leclercq, Pier D. Lambiase, Serge Boveda, Rui Providência, Dominique Babuty, Daniel Gras, Laurent Fauchier, Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), The Heart Hospital [London], University College of London [London] (UCL), Cardiac Stimulation and Rhythmology, CHU Grenoble, Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre cardiologique du Nord (CCN), Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire de Recherche en Imagerie : Méthodes d'imagerie des Échanges transcapillaires (LRI - EA4062), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier de Versailles André Mignot (CHV), Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Service de Cardiologie B, Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Dorogoichenko, Aleksandra

Subjects
medicine.medical_specialty, Framingham Risk Score, business.industry, Mortality rate, medicine.medical_treatment, Atrial fibrillation, medicine.disease, Ventricular tachycardia, Implantable cardioverter-defibrillator, Confidence interval, Sudden cardiac death, [SHS]Humanities and Social Sciences, Heart failure, Internal medicine, Cardiology, Medicine, [SHS] Humanities and Social Sciences, business, ComputingMilieux_MISCELLANEOUS
Abstract

The objective of this study was to investigate the feasibility of identifying heart failure patients who are less likely to benefit from implantable cardioverter-defibrillator (ICD) therapy among those eligible for primary prevention ICDs.The cost-effectiveness of ICDs in primary prevention may be improved dramatically.Using a cause-of-death analysis approach, we evaluated the discriminative and predictive values of a risk score with regard to overall mortality and specific causes of death by examining 2,485 patients enrolled in the French Primary Prevention ICD program (2002 to 2012). The risk score included points for New York Heart Association functional class III or greater, age70 years, QRS duration120 ms, atrial fibrillation, and glomerular filtration rate 60 ml/min. Sensitivity analyses were performed for ischemic and nonischemic cardiomyopathy, as well as for patients undergoing cardiac resynchronization therapy.After a mean follow-up of 3.0 ± 2.1 years, the overall mortality rate was 5.9 per 100 patient-years (95% confidence interval: 5.4 to 6.5), which increased with the number of risk factors (0 to 5, respectively), as follows: 2.5, 2.9, 4.8, 9.0, 12.3, and 14.8 per 100 patient-years (p 0.001). The higher mortality rate among patients with the highest scores resulted from an increase in nonarrhythmic mortality (from 2.1 to 14.8 per 100 patient-years, p 0.001), whereas the occurrence of appropriate ICD therapies did not change significantly across the categories. The C statistic testing of the score was observed to be highly similar for patients with ischemic cardiomyopathy (0.685) and nonischemic cardiomyopathy (0.658) and those receiving cardiac resynchronization therapy (0.678).Our findings suggest the feasibility of and interest in identifying patients eligible for primary prevention ICD implantation who are at significant risk of nonarrhythmic death in the real-world setting.

Published
2015

9. Implantable cardioverter-defibrillator therapy among patients with non-ischaemic vs. ischaemic cardiomyopathy for primary prevention of sudden cardiac death.

Author

Amara, Nelly, Boveda, Serge, Defaye, Pascal, Klug, Didier, Treguer, Préderic, Amet, Denis, Perier, Marie-Cécile, Gras, Daniel, Algalarrondo, Vincent, Bouzeman, Abdeslam, Piot, Olivier, Deharo, Jean-Claude, Fauchier, Laurent, Babuty, Dominique, Bordachar, Pierre, Sadoul, Nicolas, Marijon, Eloi, Leclercq, Christophe, Treguer, Fréderic, and DAI-PP Investigators

Abstract

Aim: The magnitude of benefit related to implantable cardioverter defibrillator (ICD) therapy for primary prevention of sudden cardiac death (SCD) in non-ischaemic cardiomyopathy (NICM) and ischaemic cardiomyopathy (ICM) has not been evaluated extensively in clinical practice.Methods and results: Of the 5539 consecutive patients enrolled in the multicentre Défibrillateur Automatique Implantable-Prévention Primaire (DAI-PP) study (2002-12), 5485 patients (with information on underlying heart disease) were included in the present analysis: 2181 (39.8%) had NICM and 3304 (60.2%) had ICM. ICM patients were older (63.7 ±10.3 vs. 60.6 ± 12.2 years, P < 0.0001), with a higher ejection fraction [27% (25-30) vs. 25% (20-30), P < 0.0001], narrower QRS (37.3% vs. 21.4% with QRS <120, P < 0.0001), and higher prevalence of sinus rhythm (77.3% vs. 74.0%, P = 0.009). During a mean follow-up of 3.1 ± 2.2 years, 814 patients died, giving a mortality incidence of 48.6 per 1000 person-years [95% confidence interval (CI) 45.2-51.9], higher among ICM patients (52.3, 95% CI 47.8-56.7) than in NICM patients (42.4, 95% CI 37.3-47.6; P = 0.008) (adjusted hazard ratio 1.31, 95% CI 1.06-1.61, P = 0.01). The increase in mortality among ICM patients was mainly due to non-cardiovascular mortality (P = 0.0002), whereas incidences of cardiovascular mortality (including ICD-unresponsive SCD) were similar in the two groups. Incidences of appropriate ICD interventions (anti-tachycardia pacing, shocks) were similar, but inappropriate therapies were more frequent in NICM (7.94 vs. 5.96%; P = 0.005).Conclusion: NICM and ICM patients had a same rate of ICD therapy for primary prevention of SCD in everyday practice. But, ICM patients more often died of a non- cardiovascular cause of death.Clinical Trial Registration: NCT 01992458. [ABSTRACT FROM AUTHOR]

Published
2018
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10. Dual- vs. single-chamber defibrillators for primary prevention of sudden cardiac death: long-term follow-up of the Défibrillateur Automatique Implantable-Prévention Primaire registry.

Author

Defaye, Pascal, Boveda, Serge, Klug, Didier, Beganton, Frankie, Piot, Olivier, Narayanan, Kumar, Périer, Marie-Cécile, Gras, Daniel, Fauchier, Laurent, Bordachar, Pierre, Algalarrondo, Vincent, Babuty, Dominique, Deharo, Jean-Claude, Leclercq, Christophe, Marijon, Eloi, Sadoul, Nicolas, and DAI-PP Investigators

Subjects
ARRHYTHMIA diagnosis, ARRHYTHMIA treatment, CARDIAC arrest prevention, PREVENTIVE health services, ARRHYTHMIA, CARDIAC arrest, CLINICAL trials, COMPARATIVE studies, CAUSES of death, ELECTRIC countershock, IMPLANTABLE cardioverter-defibrillators, RESEARCH methodology, MEDICAL cooperation, PROSTHETICS, COMPLICATIONS of prosthesis, RESEARCH, TIME, EVALUATION research, TREATMENT effectiveness, ACQUISITION of data, RETROSPECTIVE studies, DISEASE complications, EQUIPMENT & supplies
Abstract

Aims: Implantable cardioverter defibrillators (ICDs) are an effective primary prevention of sudden cardiac death. We examined whether dual-chamber (DC) ICDs confer a greater benefit than single-chamber (SC) ICDs, and compared the long-term outcomes of recipients of each type of device implanted for primary prevention.Methods and Results: Between 2002 and 2012, the DAI-PP registry consecutively enrolled 1258 SC- and 1280 DC-ICD recipients at 12 French medical centres. The devices were interrogated at 4- to 6-month intervals during outpatient visits, with a focus on the therapies delivered. The study endpoints were incidence of appropriate therapies, ICD-related morbidity, and deaths from all and from specific causes. The mean age of the SC- and DC-ICD recipients was 59 ± 12 and 62 ± 11 years, respectively (P< 0.0001). The distribution of genders, New York Heart Association functional classes and glomerular filtration rates, and the rates of ischaemic vs. dilated cardiomyopathies and of defibrillation tests at implant, were similar in both study groups. The rates of periprocedural complications were 12.1% in the DC- vs. 8.8% in the SC-ICD groups (P= 0.008). Over a mean follow-up of 3.1 ± 2.2 years, pulse generators were replaced in 21.9% of the DC- vs. 13.6% of the SC-ICD group (P< 0.0001). The proportions of patients treated with ≥1 appropriate therapies (24.7 vs. 23.8%) and ≥1 inappropriate shocks (8.4 vs. 7.8%), and all-cause mortality (12.4 vs. 13.2%) were similar in both groups.Conclusion: In this large registry of ICD implanted for primary prevention, DC-ICDs were associated with higher rates of peri-implant complications and generator replacements, whereas the survival and rates of inappropriate shocks were similar in both groups.Clinical Trial Number: NCT#01992458. [ABSTRACT FROM AUTHOR]

Published
2017
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11. Very high rate programming in primary prevention patients with reduced ejection fraction implanted with a defibrillator: Results from a large multicenter controlled study.

Author

Clementy, Nicolas, Challal, Farid, Marijon, Eloi, Boveda, Serge, Defaye, Pascal, Leclercq, Christophe, Deharo, Jean-Claude, Sadoul, Nicolas, Klug, Didier, Piot, Olivier, Gras, Daniel, Bordachar, Pierre, Algalarrondo, Vincent, Fauchier, Laurent, Babuty, Dominique, and DAI-PP Investigators

Abstract

Background: Programming implantable cardioverter-defibrillators (ICDs) with a high-rate therapy strategy has proven to be effective in reducing shocks and is associated with a reduced mortality.Objective: We sought to determine the impact of a very high rate cutoff programming strategy on outcomes in patients with a primary indication for an ICD due to reduced left ventricular ejection fraction.Methods: Using data from the multicenter French DAI-PP registry, this cohort-controlled study compared outcomes in 500 patients programmed with a very high rate cutoff (VH-RATE group: monitor zone 170-219 beats/min; ventricular fibrillation zone ≥220 beats/min with 13 ± 4 detection intervals) with 1500 matched control patients programmed with 1 or 2 therapy zone. All ICDs were implanted for primary prevention in patients with systolic dysfunction. Risks of events were compared after propensity score matching of sex, age, ejection fraction, New York Heart Association class, cardiomyopathy, atrial fibrillation, and type of device.Results: After a mean follow-up of 3.6 ± 2.3 years, VH-RATE programming was associated with a reduction of appropriate therapy risk (hazard ratio [HR] 0.40; 95% confidence interval [CI] 0.31-0.51; P < .0001) and inappropriate shock (HR 0.42; 95% CI 0.27-0.63; P < .0001). It was also associated with a decreased risk of sudden cardiac death (HR 0.43; 95% CI 0.17-0.99; P = .04) as compared with patients programmed with 2 therapy zones. There was no significant difference in overall survival between the groups.Conclusion: In patients implanted with an ICD in primary prevention with left ventricular dysfunction, very high rate cutoff programming (single therapy zone ≥220 beats/min) was associated with a 60% reduction of appropriate therapies as well as inappropriate shocks, without affecting mortality. [ABSTRACT FROM AUTHOR]

Published
2017
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12. Impact of early complications on outcomes in patients with implantable cardioverter-defibrillator for primary prevention.

Author

Ascoeta, Maria Soledad, Marijon, Eloi, Defaye, Pascal, Klug, Didier, Beganton, Frankie, Perier, Marie-Cécile, Gras, Daniel, Algalarrondo, Vincent, Deharo, Jean-Claude, Leclercq, Christophe, Fauchier, Laurent, Babuty, Dominique, Bordachar, Pierre, Sadoul, Nicolas, Boveda, Serge, Piot, Olivier, and DAI-PP Investigators

Abstract

Background: The lifesaving benefit of implantable cardioverter-defibrillators (ICDs) has been demonstrated. Their use has increased considerably in the past decade, but related complications have become a major concern.Objective: The purpose of this study was to assess the incidence and effect on outcomes of early (≤30 days) complications after ICD implantation for primary prevention in a large French population.Methods: We analyzed data from 5539 patients from the multicenter French DAI-PP (Défibrillateur Automatique Implantable-Prévention Primaire) registry (2002-2012) who had coronary artery disease or dilated cardiomyopathy and were implanted with an ICD for primary prevention.Results: Overall, early complications occurred in 707 patients (13.5%), mainly related to lead dislodgment or hematoma (57%). Independent factors associated with occurrence of early complications were severe renal impairment (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.17-2.37, P = .02), age ≥75 years (OR 1.01, 95% CI 1.00-1.02, P = .03), cardiac resynchronization therapy (OR 1.58, 95% CI 1.16-2.17, P = .01), and anticoagulant therapy (OR 1.28, 95% CI 1.02-1.61, P = .03). During a mean ± SD follow-up of 3.1 ± 2.3 years, 824 (15.8%) patients experienced ≥1 late complication (>30 days), and 782 (14.9%) patients died. After adjustment, early complications remained associated with occurrence of late complications (OR 2.15, 95% CI 1.73-2.66, P < .0001) and mortality (OR 1.70, 95% CI 1.34-2.17, P = .003).Conclusion: Early complications are common after ICD implantation for primary prevention, occurring in 1 in 7 patients, and are associated with an increased risk of late complications and overall mortality. Further studies are needed to investigate the underlying mechanisms of such associations. [ABSTRACT FROM AUTHOR]

Published
2016
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13. Outcomes in Guideline-Based Versus Off-Guideline Primary Prevention Implantable Cardioverter-Defibrillator Recipients.

Author

Escande, William, Boveda, Serge, Defaye, Pascal, Leclercq, Christophe, Sadoul, Nicolas, Perier, Marie-Cecile, Deharo, Jean-Claude, Fauchier, Laurent, Marijon, Eloi, Piot, Olivier, and DAI-PP Investigators

Subjects
*DILATED cardiomyopathy, *CARDIAC pacing, *IMPLANTABLE cardioverter-defibrillators, *PATIENTS, *TREATMENT of cardiomyopathies, *COMPARATIVE studies, *ELECTRIC countershock, *LONGITUDINAL method, *RESEARCH methodology, *MEDICAL cooperation, *MEDICAL protocols, *CARDIOMYOPATHIES, *PREVENTIVE health services, *RESEARCH, *EVALUATION research, *TREATMENT effectiveness, *DIAGNOSIS
Published
2017
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