Prospective evaluation of health status, quality of life and clinical outcomes following implantable defibrillator generator exchange

查看全文 作　　者：Faisal M [1]Merchant;John [2]Larson;Leon [1]Darghosian;Paige [1]Smith;Soroosh [1]Kiani;Stacy [1]Westerman;Anand [1]D.Shah;David [1,3]S.Hirsh;Michael [1]S.Lloyd;Angel [1]R.Leon;Mikhael F.El-[1]Chami 机构地区：[1]Section of Cardiac Electrophysiology,Emory University School of Medicine,Atlanta,GA,USA;[2]Department of Medicine,University of Michigan School of Medicine,Ann Arbor,MI,USA;[3]Grady Health System,Atlanta,GA,USA 出　　处：《Journal of Geriatric Cardiology》索引2021年第18卷第9期,共8页 基　　金：supported by a Pilot Translational&Clinical Studies Program grant from the National Center for Advancing Translational Studies of the National Institutes of Health(UL1TR002378);a FAME grant from the Emory University Department of Medicine。 摘　　要：BACKGROUND Little is known about health status and quality of life(QoL)after implantable cardioverter-defibrillator(ICD)generator exchange(GE).METHODS We prospectively followed patients undergoing first-time ICD GE.Serial assessments of health status were performed by administering the 36-Item Short Form Survey(SF-36).RESULTS Mean age was 67.5±14.3 years,left ventricle ejection fraction(LVEF)was 36.5%±15.0%and over 40%of the cohort had improved LVEF to>35%at the time of GE.SF-36 scores were significantly worse in physical/general health domains compared to domains of emotional/social well-being(P<0.001 for each comparison).Physical health scores were significantly worse among those with medical comorbidities including diabetes,chronic obstructive pulmonary disease and atrial fibrillation.Mean follow-up was 1.6±0.5 years after GE.Overall SF-36 scores remained stable across all domains during follow-up.Survival at 3 years post-GE was estimated at 80%.Five patients died during follow-up and most deaths were adjudicated as non-arrhythmic in origin.Four patients experienced appropriate ICD shocks after GE,three of whom had LVEF which remains impaired LVEF(i.e.,<35%)at the time of GE.CONCLUSION Patients undergoing ICD GE have significantly worse physical health compared to emotional/social well-being,which is associated with the presence of medical comorbidities.In terms of clinical outcomes,the incidence of appropriate shocks after GE among those with improvement in LVEF is very low,and most deaths post-procedure appear to be non-arrhythmic in origin.These data represent an attempt to more fully characterize the spectrum of QoL and clinical outcomes after GE. 关 键 词：ICD quality of life and clinical outcomes following implantable defibrillator generator exchange Prospective evaluation of health status