Implantable cardioverter defibrillators (ICDs) reduce the risk of sudden cardiac death but may increase the risk of subsequent heart failure in patients who live longer, according to a study published in Circulation: Journal of the American Heart Association.
"Some patients whose lives were prolonged by ICDs were sicker and more prone to develop heart failure," said Ilan Goldenberg, M.D., research assistant professor at the University of Rochester Medical Center and lead author of the latest report from the Multicenter Automatic Defibrillator Implantation Trial-II (MADIT-II). "The ICD kept them alive by preventing sudden cardiac death as their heart disease naturally progressed to heart failure.
"Patients who developed heart failure had almost four times the increase in risk of death during follow up. This study should direct more attention to the prevention of heart failure in patients receiving an ICD."
The MADIT-II trial included 1,232 heart attack patients with an ejection fraction of 30 percent or less who had a heart attack at least a month before enrollment. Researchers randomly assigned patients to ICD (single or dual chamber) or best medical care.
Ejection fraction is a measure of the heart's ability to efficiently pump blood to other parts of the body. An ejection fraction of 60 percent is healthy, so the MADIT-II patients were pumping blood at about half the rate of healthy people.
Compared to patients who received only medical therapy after a heart attack, those who had ICDs implanted were 39 percent more likely to have a first hospitalization for heart failure and 58 percent more likely to be hospitalized for recurrent heart failure during an average 20-month follow up.
The overall survival benefit was 42 percent for patients who received a single chamber ICD and 51 percent for those with a dual chamber. Researchers analyzed data from 1,224 study patients, including 402 who received single-chamber devices and 313 who were implanted with dual-chamber devices.
Twenty-three percent of patients who received ICDs in the MADIT-II trial were hospitalized for HF during 20 months of follow-up versus 17 percent of patients who received only medical therapy.
Patients who received single-chamber devices did not suffer a reduced survival benefit if they developed heart failure. However, patients who were implanted with dual-chamber devices had a significant reduction in survival benefit after heart failure, Goldenberg said.
Karen Astle | EurekAlert!
UTSA study describes new minimally invasive device to treat cancer and other illnesses
02.12.2016 | University of Texas at San Antonio
Earlier Alzheimer's diagnosis may be possible with new imaging compound
02.11.2016 | Washington University School of Medicine
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water
In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...
The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.
Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
02.12.2016 | Medical Engineering
02.12.2016 | Agricultural and Forestry Science
02.12.2016 | Physics and Astronomy