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2009 Southern Regional Meeting Abstracts
Session: Joint Plenary Poster Session and Reception
EFFECT OF RENAL DISEASE ON SURVIVAL IN PATIENTS WITH IMPLANTABLE CARDIOVERTER DEFIBRILLATORS
Bissett J1,2, Matin Z2, Leonardi M1,2, Sachdev R1,2. 1University of Arkansas for Medical Sciences, Little Rock, AR and 2Central Arkansas Veterans Healthcare System, Little Rock, AR.
Purpose of Study: The purpose of this study was to compare the survival rate of the patients with varying degrees of renal disease in patients with Implantable cardioverter defibrillators (ICD).
Methods Used: The data were obtained from a web based ICD database and a computerized medical record system for consecutive three hundred patients (n=300), who had their ICD implantation at least three years before from the date of the statistical analysis were included in this study. These patients were grouped into three different groups, depending on their glomerular filtration rate (GFR, ml/min/1.73m2), obtained before the implantation of the Implantable cardioverter defibrillator ICD, i.e., normal stage, NRF or stage 1, GFR≥60 or above; moderate CKD or, stage 2, or GFR30-59, and severe CKD stage, or stage 3, GFR<30.
Summary of Results: (1) Survival for 124 patients with GFR≥60 ml/min/1.73m2 was 98/124 (79.0%) with mean follow up of 1225.5±390.4 days (2) Survival for 141 patients with GFR 30-59 ml/min/1.73m2 was 91/141 (64.5%) with mean follow up of 1080.7±481.9 days. (3) Survival for 35 patients with GFR<30 ml/min/1.73m2 was 11/35 (31.4%) with mean follow up of 719.0±527.2 days. The p value for comparison of each group with all other groups was, p <0.01.
Survival rate compared between BiV pacing versus NonBiV pacing did not improve survival in any of three groups divided according to their GFR. Normal stage, NRF or stage 1, GFR≥60 or above; (5/17, 29.4% vs. 21/107, 19.6%, p=0.27); moderate CKD or, stage 2, BiV vs. NonBiV (9/20, 45.0% vs. 41/121, 33.8%, p=0.33); or stage 3, GFR<30, BiV vs. NonBiV (5/8, 62.5% vs. 19/27, 70.3%, p=0.69).
Conclusions: (1) GFR remains a strong predictor of survival in patients with Implantable cardioverter defibrillators (ICD). (2) BiV pacing in patients with congestive heart failure (CHF) with chronic renal disease does not improve survival to the level of the patients without BiV pacing. (3) Further study is required to identify the treatable factors that could improve survival.
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