Factors Affecting The Appropriate And Inappropriate Shocks Of Implantable Cardioverter Defibrillator

Objective:To explore the factors influencing the appropriate and inappropriate shocks of an implantable cardioverter defibrillator.Methods: Patients with ICD and CRT-D implantation in our hospital from April 2014 to November 2019 were selected for regular follow-up,and the subjects who met the inclusion and exclusion criteria were screened out.The patients were divided into appropriate shock group and non-appropriate shock group according to whether they received appropriate shock treatment after operation.The baseline data such as gender,age,type of pacemaker,complications,medication situation,clinical data such as creatinine,QRS time,QT interval and LVEF were compared.Binary logistic regression was used to explore the influencing factors of appropriate shock treatment.The patients were divided into inappropriate shock group and non-inappropriate shock group according to whether they received inappropriate shock treatment after operation.Baseline data such as gender,age,type of pacemaker,complications,medication situation,clinical data such as creatinine,QRS time,QT interval and LVEF were compared.Binary logistic regression was used to explore the influencing factors of inappropriate shock treatment.Results: A total of 67 patients were followed up,with a median follow-up time of13 months.Thirty-five patients were found to have received ICD shock treatment during postoperative follow-ups,11 patients had inappropriate shocks and 24 patients had appropriate shocks.The remaining 32 patients did not receive shock treatment.Compared with the non-appropriate shock group,the appropriate shock group had a lower LVEF,median(30.50% vs 39.00%,P=0.023),and proportion ofstatin-related drug use(41.7% vs 72.1%,P=0.014).Through binary logistics regression,we found that LVEF(P=0.037,OR=0.917)and statins(P=0.041,OR=0.180)were the influencing factors of appropriate shocks.Compared with the non-inappropriate shock group,the inappropriate shock group presented a higher incidence of atrial fibrillation(54.5% vs 10.7%,P<0.001),and a lower proportion of statin-related drug use(27.3% vs 67.9%,P=0.011);Through binary logistics regression,we found that History of atrial fibrillation(P=0.039,OR=2.137)is the influencing factor of inappropriate shocks.Conclusion: LVEF is the influencing factor of appropriate shocks therapy and atrial fibrillation is the influencing factor of inappropriate shocks therapy after ICD operation.