학술논문
Ventricular arrhythmias following coronary artery bypass grafting for ischemic cardiomyopathy: When to insert an implanted cardioverter defibrillator?Central MessagePerspective
Document Type
article
Author
Masaro Nakae, MD; Satoshi Kainuma, MD, PhD; Koichi Toda, MD, PhD; Daisuke Yoshioka, MD, PhD; Takuji Kawamura, MD, PhD; Ai Kawamura, MD, PhD; Noriyuki Kashiyama, MD, PhD; Sho Komukai, PhD; Tetsuhisa Kitamura, MD, MS, DPH; Atsushi Hirayama, MD, MPH; Yoshimitsu Shimomura, MD; Kazuhiro Taniguchi, MD, PhD; Shigeru Miyagawa, MD, PhD
Source
JTCVS Open, Vol 13, Iss , Pp 163-175 (2023)
Subject
Language
English
ISSN
2666-2736
Abstract
Objectives: The study objectives were to determine the incidence, predictors, and clinical impact of ventricular arrhythmias after coronary artery bypass grafting and to evaluate the impact of implantable cardioverter defibrillators on the survival of patients with ventricular arrhythmias. Methods: We enrolled 498 patients with a left ventricular ejection fraction of 40% or less who underwent coronary artery bypass grafting between 1993 and 2015. Clinical follow-up was completed in 94.0% of patients, with a median follow-up of 58.4 months. Results: Overall, 212 patients (43%) died, mainly of heart failure (n = 54, 10.8%) or sudden cardiac death (n = 40, 8.0%). The sudden cardiac death rate was highest during the first 6 months, with a monthly rate of 0.37%. Overall, 99 patients (20%) developed postoperative ventricular arrhythmias, and implantable cardioverter defibrillator was implanted in 55 patients. Previous ventricular arrhythmias (hazard ratio, 3.22; 95% confidence interval, 1.98-5.24; P