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Europace 2004 6(2):151-158; doi:10.1016/j.eupc.2003.11.008
© 2004 by European Society of Cardiology
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Mortality of patients with implanted cardioverter/defibrillators in relation to episodes of atrial fibrillation

Thomas Denekea,*, Thomas Lawoa, Bart Gerritseb, Bernd Lemkea and for the European GEM DRTM Investigators

aBerufsgenossenschaftliche Kliniken Bergmannsheil Bochum, Germany; bBakken Research Center Maastricht, The Netherlands

AIMS: This study was undertaken to evaluate if a history of episodes of atrial fibrillation (AF) has an effect on survival in patients (pts) with implanted cardioverter defibrillators (ICD).

METHODS AND RESULTS: Retrospective analysis of baseline characteristics, medication and endpoints in pts receiving a dual-chamber ICD comparing pts without (group 1: n=291) and with a history of AF (group 2: n=68).

Pts in groups 1 and 2 did not differ with regard to baseline characteristics. Forty-one pts (8.7%) experienced a detected episode of AF.

During the study period (mean follow-up 9.5 months) 25 pts died (5.8% of group 1 vs 11.8% of group 2). Patient survival was found to be 97.9% vs 91.2% (n=279 vs 63) at 3 months after implantation, 97.5% vs 89.7% (n=244 vs 54) at 6 months, and 93.7% vs 86.5% (n=96 vs 28) at 12 months in group 1 vs group 2 (p=0.005).

The risk of death increased after a first episode of AF was experienced during follow-up (RR=5.0, p=0.0007). Independent predictors of mortality are NYHA class (p=0.002), history of AF (p=0.009 for predicting early mortality), and detected episodes of AF during follow-up (p=0.001).

CONCLUSION: ICD-patients with a history of AF had a higher than average risk of death early after implantation and after device-detected episodes of AF.

Key Words: recurrent atrial fibrillation, implantable defibrillators, mortality

*Corresponding author. Department of Cardiology, "Bergmannsheil Bochum", Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany. Tel.: +49-234-302-6077; fax: +49-234-302-6084. E-mail address: thomas.deneke{at}ruhr-uni-bochum.de (T.Deneke).


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