Syncope in ICD recipients: a single centre experience

Parisha Khan; Karshana Selvarajah; Sheena Gohel; Baldeep S. Sidhu; Antonio Cannatà; Daniel I. Bromage; Theresa McDonagh; Francis Murgatroyd; Paul A. Scott

doi:10.1093/europace/euac281

Syncope in ICD recipients: a single centre experience

Parisha Khan, Karshana Selvarajah, Sheena Gohel, Baldeep S. Sidhu, Antonio Cannatà, Daniel I. Bromage, Theresa McDonagh, Francis Murgatroyd, Paul A. Scott

KCH King's College Hospital NHS Foundation Trust

Research output: Contribution to journal › Article › peer-review

Abstract

AIMS: There is little evidence of the impact of syncope in implantable cardioverter-defibrillator (ICD) patients in routine community hospital care. This single-centre retrospective study sought to evaluate the incidence and prognostic significance of syncope in consecutive ICD patients. METHODS AND RESULTS: Data were collected on consecutive patients undergoing first ICD implantation between January 2009 and December 2019. The primary endpoints were the first occurrence of all-cause syncope, all-cause mortality, and all-cause hospitalization. Multivariate Cox proportional hazard models were used to identify risk factors associated with syncope and to analyse the subsequent risk of mortality and hospitalization. 1003 patients (58% primary prevention) were included in the final analysis. During a mean follow-up of 1519 ± 1055 days, 106 (10.6%) experienced syncope, 304 died (30.3%), and 477 (47.5%) were hospitalized for any cause. In an analysis adjusted for baseline variables, the first occurrence of syncope was associated with a significantly increased risk of mortality (HR 2.82, P < 0.001) and the first occurrence of hospitalization (HR 2.46, P = 0.002). CONCLUSION: Syncope in ICD recipients is common and associated with a poor prognosis irrespective of baseline variables and ICD programming. The occurrence of syncope is associated with a significant increase in the risk of mortality and hospitalization.

Original language	English
Pages (from-to)	940-947
Number of pages	8
Journal	Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
Volume	25
Issue number	3
DOIs	https://doi.org/10.1093/europace/euac281
Publication status	Published - 14 Jan 2023

Keywords

Hospital admission
Implantable cardioverter-defibrillator
Programming
Shocks
Syncope

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Khan, P., Selvarajah, K., Gohel, S., Sidhu, B. S., Cannatà, A., Bromage, D. I., McDonagh, T., Murgatroyd, F., & Scott, P. A. (2023). Syncope in ICD recipients: a single centre experience. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 25(3), 940-947. https://doi.org/10.1093/europace/euac281

Khan, Parisha ; Selvarajah, Karshana ; Gohel, Sheena et al. / Syncope in ICD recipients : a single centre experience. In: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2023 ; Vol. 25, No. 3. pp. 940-947.

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title = "Syncope in ICD recipients: a single centre experience",

abstract = "AIMS: There is little evidence of the impact of syncope in implantable cardioverter-defibrillator (ICD) patients in routine community hospital care. This single-centre retrospective study sought to evaluate the incidence and prognostic significance of syncope in consecutive ICD patients. METHODS AND RESULTS: Data were collected on consecutive patients undergoing first ICD implantation between January 2009 and December 2019. The primary endpoints were the first occurrence of all-cause syncope, all-cause mortality, and all-cause hospitalization. Multivariate Cox proportional hazard models were used to identify risk factors associated with syncope and to analyse the subsequent risk of mortality and hospitalization. 1003 patients (58% primary prevention) were included in the final analysis. During a mean follow-up of 1519 ± 1055 days, 106 (10.6%) experienced syncope, 304 died (30.3%), and 477 (47.5%) were hospitalized for any cause. In an analysis adjusted for baseline variables, the first occurrence of syncope was associated with a significantly increased risk of mortality (HR 2.82, P < 0.001) and the first occurrence of hospitalization (HR 2.46, P = 0.002). CONCLUSION: Syncope in ICD recipients is common and associated with a poor prognosis irrespective of baseline variables and ICD programming. The occurrence of syncope is associated with a significant increase in the risk of mortality and hospitalization.",

keywords = "Hospital admission, Implantable cardioverter-defibrillator, Programming, Shocks, Syncope",

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Khan, P, Selvarajah, K, Gohel, S, Sidhu, BS , Cannatà, A , Bromage, DI , McDonagh, T, Murgatroyd, F & Scott, PA 2023, 'Syncope in ICD recipients: a single centre experience', Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, vol. 25, no. 3, pp. 940-947. https://doi.org/10.1093/europace/euac281

Syncope in ICD recipients: a single centre experience. / Khan, Parisha; Selvarajah, Karshana; Gohel, Sheena et al.
In: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, Vol. 25, No. 3, 14.01.2023, p. 940-947.

Research output: Contribution to journal › Article › peer-review

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T1 - Syncope in ICD recipients

T2 - a single centre experience

AU - Khan, Parisha

AU - Selvarajah, Karshana

AU - Gohel, Sheena

AU - Sidhu, Baldeep S.

AU - Cannatà, Antonio

AU - Bromage, Daniel I.

AU - McDonagh, Theresa

AU - Murgatroyd, Francis

AU - Scott, Paul A.

N1 - Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.

PY - 2023/1/14

Y1 - 2023/1/14

N2 - AIMS: There is little evidence of the impact of syncope in implantable cardioverter-defibrillator (ICD) patients in routine community hospital care. This single-centre retrospective study sought to evaluate the incidence and prognostic significance of syncope in consecutive ICD patients. METHODS AND RESULTS: Data were collected on consecutive patients undergoing first ICD implantation between January 2009 and December 2019. The primary endpoints were the first occurrence of all-cause syncope, all-cause mortality, and all-cause hospitalization. Multivariate Cox proportional hazard models were used to identify risk factors associated with syncope and to analyse the subsequent risk of mortality and hospitalization. 1003 patients (58% primary prevention) were included in the final analysis. During a mean follow-up of 1519 ± 1055 days, 106 (10.6%) experienced syncope, 304 died (30.3%), and 477 (47.5%) were hospitalized for any cause. In an analysis adjusted for baseline variables, the first occurrence of syncope was associated with a significantly increased risk of mortality (HR 2.82, P < 0.001) and the first occurrence of hospitalization (HR 2.46, P = 0.002). CONCLUSION: Syncope in ICD recipients is common and associated with a poor prognosis irrespective of baseline variables and ICD programming. The occurrence of syncope is associated with a significant increase in the risk of mortality and hospitalization.

AB - AIMS: There is little evidence of the impact of syncope in implantable cardioverter-defibrillator (ICD) patients in routine community hospital care. This single-centre retrospective study sought to evaluate the incidence and prognostic significance of syncope in consecutive ICD patients. METHODS AND RESULTS: Data were collected on consecutive patients undergoing first ICD implantation between January 2009 and December 2019. The primary endpoints were the first occurrence of all-cause syncope, all-cause mortality, and all-cause hospitalization. Multivariate Cox proportional hazard models were used to identify risk factors associated with syncope and to analyse the subsequent risk of mortality and hospitalization. 1003 patients (58% primary prevention) were included in the final analysis. During a mean follow-up of 1519 ± 1055 days, 106 (10.6%) experienced syncope, 304 died (30.3%), and 477 (47.5%) were hospitalized for any cause. In an analysis adjusted for baseline variables, the first occurrence of syncope was associated with a significantly increased risk of mortality (HR 2.82, P < 0.001) and the first occurrence of hospitalization (HR 2.46, P = 0.002). CONCLUSION: Syncope in ICD recipients is common and associated with a poor prognosis irrespective of baseline variables and ICD programming. The occurrence of syncope is associated with a significant increase in the risk of mortality and hospitalization.

KW - Hospital admission

KW - Implantable cardioverter-defibrillator

KW - Programming

KW - Shocks

KW - Syncope

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Khan P, Selvarajah K, Gohel S, Sidhu BS , Cannatà A , Bromage DI et al. Syncope in ICD recipients: a single centre experience. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2023 Jan 14;25(3):940-947. doi: 10.1093/europace/euac281

Syncope in ICD recipients: a single centre experience

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