Original scientific paper
Lower Body Mass Index and Atrial Fibrillation as Independent Predictors for Mortality in Patients with Implantable Cardioverter Defibrillator
Christiana Schernthaner
Maximilian Pichler
Bernhard Strohmer
Abstract
Aim: To evaluate risk factors related to total mortality in an unselected population of patients implanted with a cardioverter defibrillator.
Methods: Survival analysis was performed retrospectively investigating the records of 77 consecutive patients implanted with defibrillators (median 67 years, range 38-83 years; 63 men). All patients were followed regularly in 3-month intervals. The cause of mortality was assessed clinically, including post-mortem examination of device to assess possible arrhythmogenic death. Predictors were assessed by Kaplan-Meier analysis with log-rank tests and by Cox regression analysis (proportional hazards).
Results: Defibrillator recipients had a mean (±SD) ejection fraction of 34±13%, left ventricular end-diastolic dimension (LVEDD) of 6.24±0.8 cm, QRS duration of 129±34 ms, and body mass index (BMI) of 26.4±4.3 kg/m². Atrial fibrillation was present in 32 patients, paroxysmal fibrillation in 23, and permanent fibrillation in 9 patients. The estimate of mean survival time for all patients was 51.5 (95% CI 46.6-56.5) months. During the study period 11/77 (14%) patients died. Mean follow-up time was 24.5 months (range 0.2-60.7) for survivors and 7.6 months (range 1.5-42) for non-survivors. Independent predictors of mortality were the NYHA class (P=0.004), BMI≤26 kg/m² (P=0.024), presence of paroxysmal or permanent atrial fibrillation (P=0.014), and absence of arterial hypertension (P=0.010). LVEDD showed a weak significant effect on survival (P=0.049).
Keywords
atrial fibrillation; body mass index; implantable cardioverter defilator; heart failure
Hrčak ID:
9409
URI
Publication date:
20.2.2007.
Visits: 1.094 *