Evaluation with Cardiac Catheterization and Echocardiography in Patients Undergoing Implantable Cardioverter-defibrillator Implantation

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概要

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• As coronary artery disease (CAD) is common in adult patients with lethal ventricular arrhythmias, it has become accepted practice to perform coronary angiography prior to implantable cardioverter-defibrillator (ICD) implantation. Echocardiography is also commonly performed in this setting. However, we are unaware of any study that has evaluated the role of routine coronary angiography and echocardiography prior to ICD placement. We theorize that CAD and valvular heart disease are common in patients undergoing ICD Implantation and that angiography and echocardiography in this population frequently result in invasive therapy. We reviewed all cases of ICD implantation at Strong Memorial Hospital over a 14-month period and determined whether coronary angiography and echocardiography performed prior to ICD placement resulted in revasculalization and valve surgery, respectively. Of 120 patients who received an ICD, 64 (53%) had undergone coronary angiography within the prior year. Of those, 53 (83%) had CAD and 25 (39%) subsequently underwent percutaneous transluminal coronary angioplasty (PTCA) (20) or coronary artery bypass grafting (CABG) (5). Sixty two (52%) of the patients studied had had valvular heart disease diagnosed by left heart catheterization or echocardiography within the prior year. Four (6%) pateints had resultant valve surgery. We conclude that coronary angiography performed prior to ICD implantation results in the diagnosis of CAD and the subsequent revascularization in a large number of patients. Those receiving and ICD also have a high incidence of valvular heart disease, the diagnosis of which leads to valve replacement surgery in a small number of patients. There may be a role for routine coronary angiography and echocardiogram prior to ICD placement.

• 新潟大学の論文

著者

• Bhati Ravindra

  Department Of Medicine University Of Rochester Medical Center

• FILIPPONE John

  Division of Cardiology

• AKIYAMA Toshio

  Division of Cardiology

• Akiyama Toshio

  Univ. Rochester New York Usa

関連論文

• Evaluation with Cardiac Catheterization and Echocardiography in Patients Undergoing Implantable Cardioverter-defibrillator Implantation
• Possible Myocardial Stunning after Cardiac Arrest

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