Incidence of ventricular arrhythmic events in CKD patients with ICD

Abstract

AimThis study examined patients with chronic kidney disease (CKD) in stages 1, 2, 3 and 4, left ventricular dysfunction and automatic implantable cardioverter-defibrillator (ICD). Our goal was to record the appropriate therapies, “Anti-tachycardia Therapy Pacing” (ATP) and shock events during the 12months of follow-up and compare the incidence and severity of these at different stages of CKD. MethodsSeventy-six patients were evaluated once every three months till one year of follow-up. The arrhythmic events were assessed at each follow-up visit. ResultsComparing the groups, patients with CKD stage 4 had a higher number of ATP (45.1±4.4) and shock (33.3±5.0) events compared to other groups (P<0.0001 for both comparisons in relation to other groups). Along the 12months, 69% received ATP and 63% were treated with shock, P<0.0001 by Log-rank/Mantel-Haenszel test compared to the other groups. Regarding the ATP events, patients with CKD stage 4 showed the hazard ratio (HR) of 11.800, with a confidence interval of 95% (CI 95%) from 3.673 to 37,930, P<0.0001 vs. patients with CKD stage 1; HR of 7.957, with a CI 95% from 2.578 to 24.570, P<0.0001 vs. patients with CKD stage 2; and HR of 2.902, with a CI 95% 1.054–7.986, P=0.0391 vs. patients with CKD stage 3. In relation to the shock events, patients with CKD stage 4 showed the HR of 20,010, with a CI 95% from 5.262 to 76.080, P<0.0001 vs. patients with CKD stage 1; HR of 10.060 with a CI 95% 3.026–33.450, P=0.0001 vs. patients with CKD stage 2; and HR of 2.880, with a CI 95% 1.029–8.060, P=0.0323 vs. patients with CKD stage 3. ConclusionOur results suggest that the more advanced the stage of CKD higher the HR of ATP and shock events.