Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/37306
Title: The MADIT-ICD benefit score helps to select implantable cardioverter-defibrillator candidates in cardiac resynchronization therapy
Authors: DAUW, Jeroen 
Martens, Pieter
NIJST, Petra 
MEEKERS, Evelyne 
DEFERM, Sebastien 
GRUWEZ, Henri 
Rivero-Ayerza, Maximo
Van Herendael, Hugo
PISON, Laurent 
NUYENS, Dieter 
DUPONT, Matthias 
MULLENS, Wilfried 
Issue Date: 2022
Publisher: OXFORD UNIV PRESS
Source: EUROPACE, MAR 2022
Status: Early view
Abstract: Aims The aim of this study is to evaluate whether the MADIT-ICD benefit score can predict who benefits most from the addition of implantable cardioverter-defibrillator (ICD) to cardiac resynchronization therapy (CRT) in real-world patients with heart failure with reduced ejection fraction (HFrEF) and to compare this with selection according to a multidisciplinary expert centre approach. Methods and results Consecutive HFrEF patients who received a CRT for a guideline indication at a tertiary care hospital (Ziekenhuis Oost-Limburg, Genk, Belgium) between October 2008 and September 2016, were retrospectively evaluated. The MADIT-ICD benefit groups (low, intermediate, and high) were compared with the current multidisciplinary expert centre approach. Endpoints were (i) sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) and (ii) non-arrhythmic mortality. Of the 475 included patients, 165 (34.7%) were in the lowest, 220 (46.3%) in the intermediate, and 90 (19.0%) in the highest benefit group. After a median follow-up of 34 months, VT/VF occurred in 3 (1.8%) patients in the lowest, 9 (4.1%) in the intermediate, and 13 (14.4%) in the highest benefit group (P < 0.001). Vice versa, non-arrhythmic death occurred in 32 (19.4%) in the lowest, 32 (14.6%) in the intermediate, and 3 (3.3%) in the highest benefit group (P = 0.002). The predictive power for ICD benefit was comparable between expert multidisciplinary judgement and the MADIT-ICD benefit score: Uno's C-statistic 0.69 vs. 0.69 (P = 0.936) for VT/VF and 0.62 vs. 0.60 (P = 0.790) for non-arrhythmic mortality. Conclusion The MADIT-ICD benefit score can identify who benefits most from CRT-D and is comparable with multidisciplinary judgement in a CRT expert centre.
Notes: Mullens, W (corresponding author), Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium.
wilfried.mullens@zol.be
Keywords: Heart failure; Implantable cardioverter-defibrillator; Cardiac;resynchronization therapy; Patient selection; MADIT-ICD benefit score
Document URI: http://hdl.handle.net/1942/37306
ISSN: 1099-5129
e-ISSN: 1532-2092
DOI: 10.1093/europace/euac039
ISI #: WOS:000784737700001
Category: A1
Type: Journal Contribution
Appears in Collections:Research publications

Show full item record

Page view(s)

92
checked on May 27, 2022

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.