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Journal Article Multicenter Study Ppublish 13 citations

PubMed: 39299922 DOI: 10.1093/eurheartj/ehae575

Prognostic value of ventricular arrhythmia in early post-infarction left ventricular dysfunction: the French nationwide WICD-MI study.

Eur Heart J 45(41):4428-4442

Authors: Mathieu Echivard, Jean-Marc Sellal, Chloé Ziliox, Eloi Marijon, Pierre Bordachar, Sylvain Ploux, Karim Benali, Christelle Marquié, Clémence Docq, Didier Klug, Romain Eschalier, Baptiste Maille, Jean-Claude Deharo, Dominique Babuty, Thibaud Genet, Estelle Gandjbakhch, Antoine Da Costa, Olivier Piot, Damien Minois, Jean-Baptiste Gourraud, Pierre Mondoly, Philippe Maury, Serge Boveda, Jean-Luc Pasquié, Raphaël Martins, Christophe Leclercq, Charles Guenancia, Gabriel Laurent, Mathieu Becker, Julien Bertrand, Philippe Chevalier, Vladimir Manenti, Maciej Kubala, Pascal Defaye, Peggy Jacon, Antoine Desbiolles, Marc Badoz, Laurence Jesel, Nicolas Lellouche, Paul-Ursmar Milliez, Pierre Ollitrault, Samir Fareh, Matthieu Bercker, Jacques Mansourati, Benoît Guy-Moyat, Jean-Pierre Chabert, Nicolas Luconi, Pierre-François Winum, Frédéric Anselme, Fabrice Extramiana … and 15 other authors

Affiliations

  • Department of Cardiology, CHRU-Nancy, Université de Lorraine, Nancy, 1 rue du Morvan, 54500 Vandoeuvre-lès-Nancy, France.
  • IADI, INSERM U1254, Université de Lorraine, Nancy, 1 rue du Morvan, 54500 Vandoeuvre-lès-Nancy, France.
  • Department of Cardiology, Hôpital Europen Georges Pompidou, AP-HP, Université Paris Descartes, Paris, France.
  • INSERM U970, Université Paris Descartes, Paris, France.
  • Department of Cardiology, CHRU-Bordeaux, Université de Bordeaux, Bordeaux-Pessac, France.
  • IHU Liryc, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, Bordeaux, France.
  • Department of Cardiology, CHRU-Lille, Université de Lille, Lille, France.
  • Department of Cardiology, CHRU-Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France.
  • Department of Cardiology, Hôpital La Timone, AP-HM, Université Aix-Marseille, Marseille, France.
  • Department of Cardiology, CHRU-Tours, Université de Tours, Tours, France.
  • Department of Cardiology & ICAN, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, Paris, France.
  • INSERM, UMPC, Sorbonne Université, Paris, France.
  • Department of Cardiology, CHRU-Saint-Etienne, Université de Saint-Etienne Jean-Monnet, Saint-Etienne, France.
  • Department of Cardiology, Centre Cardiologique du Nord, Saint Denis, France.
  • Department of Cardiology, CHRU-Nantes, Université de Nantes, Nantes, France.
  • Department of Cardiology, Hôpital de Rangueil, CHRU-Toulouse, Université de Toulouse, Toulouse, France.
  • INSERM U1048, Université de Toulouse, Toulouse, France.
  • Department of Cardiology, Clinique Pasteur, Toulouse, France.
  • Department of Cardiology, CHRU-Montpellier, Université de Montpellier, Montpellier, France.
  • Department of Cardiology, CHRU-Rennes, Université de Rennes, Rennes, France.
  • Department of Cardiology, CHRU-Dijon, Université de Bourgogne, Dijon, France.
  • Department of Cardiology, CHR-Metz-Thionville, Metz-Ars Laquenexy, France.
  • Department of Cardiology, Hôpital Louis Pradel, HCL, Université Claude Bernard Lyon 1, Lyon-Bron, France.
  • Department of Cardiology, Hôpital Privé Claude Galien, Quincy-sous-Sénart, France.
  • Department of Cardiology, Hôpital Privé Jacques Cartier, Massy, France.
  • Department of Cardiology, CHRU-Amiens, Université de Picardie Jules Verne, Amiens, France.
  • Department of Cardiology, CHRU-Grenoble, Université de Grenoble Alpes, Grenoble, France.
  • Department of Cardiology, CHRU-Besançon, Université de Franche-Comté, Besançon, France.
  • Department of Cardiology, CHRU-Strasbourg, Université de Strasbourg, Strasbourg, France.
  • Department of Cardiology, Hôpital Henri Mondor, AP-HP, Université de Paris Est Créteil, Créteil, France.
  • Department of Cardiology, CHRU-Caen, Université de Caen Normandie, Caen, France.
  • Department of Cardiology, Hôpital de la Croix Rousse, HCL, Université Claude Bernard Lyon 1, Lyon, France.
  • Department of Cardiology, Centre Hospitalier de Boulogne-sur-Mer, Boulogne-sur-Mer, France.
  • Department of Cardiology, CHRU-Brest, Université de Bretagne Occidentale, Brest, France.
  • Department of Cardiology, CHRU-Limoges, Université de Limoges, Limoges, France.
  • Department of Cardiology, CHRU-Reims, Université de Reims Champagne-Ardenne, Reims, France.
  • Department of Cardiology, CHRU-Nîmes, Université de Nîmes, Nîmes, France.
  • Department of Cardiology, CHRU-Rouen, Université de Rouen, Rouen, France.
  • Department of Cardiology, Hôpital Bichat, AP-HP, Université Paris-Cité, Paris, France.

Abstract

BACKGROUND AND AIMS

Prophylactic implantable cardioverter-defibrillators (ICDs) are not recommended until left ventricular ejection fraction (LVEF) has been reassessed 40 to 90 days after an acute myocardial infarction. In the current therapeutic era, the prognosis of sustained ventricular arrhythmias (VAs) occurring during this early post-infarction phase (i.e. within 3 months of hospital discharge) has not yet been specifically evaluated in post-myocardial infarction patients with impaired LVEF. Such was the aim of this retrospective study.

METHODS

Data analysis was based on a nationwide registry of 1032 consecutive patients with LVEF ≤ 35% after acute myocardial infarction who were implanted with an ICD after being prescribed a wearable cardioverter-defibrillator (WCD) for a period of 3 months upon discharge from hospital after the index infarction.

RESULTS

ICDs were implanted either because a sustained VA occurred while on WCD (VA+/WCD, n = 72) or because LVEF remained ≤35% at the end of the early post-infarction phase (VA-/WCD, n = 960). The median follow-up was 30.9 months. Sustained VAs occurred within 1 year after ICD implantation in 22.2% and 3.5% of VA+/WCD and VA-/WCD patients, respectively (P < .0001). The adjusted multivariable analysis showed that sustained VAs while on WCD independently predicted recurrence of sustained VAs at 1 year (adjusted hazard ratio [HR] 6.91; 95% confidence interval [CI] 3.73-12.81; P < .0001) and at the end of follow-up (adjusted HR 3.86; 95% CI 2.37-6.30; P < .0001) as well as 1-year mortality (adjusted HR 2.86; 95% CI 1.28-6.39; P = .012).

CONCLUSIONS

In patients with LVEF ≤ 35%, sustained VA during the early post-infarction phase is predictive of recurrent sustained VAs and 1-year mortality.

MeSH

Mortality, Myocardial Infarction, Ventricular Dysfunction, Arrhythmias, Cardiac, Ventricular Dysfunction, Left, Cardiology, Defibrillators