Cigarette Smoking and the Risk of Supraventricular and Ventricular Tachyarrhythmias in High‐Risk Cardiac Patients with Implantable Cardioverter Defibrillators

Journal of Cardiovascular Electrophysiology - Tập 17 Số 9 - Trang 931-936 - 2006
Ilan Goldenberg1, Arthur J. Moss1, Scott McNitt1, Wojciech Zaręba1, James P. Daubert1, William J. Hall2, Mark Andrews1
1Cardiology Unit of the Department of Medicine
2Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York, USA

Tóm tắt

Introduction: Nicotine elevates serum catecholamine concentration and is therefore potentially arrhythmogenic. However, the effect of cigarette smoking on arrhythmic risk in coronary heart disease patients is not well established. Methods and Results: The risk of appropriate and inappropriate defibrillator therapy by smoking status was analyzed in 717 patients who received an implantable cardioverter defibrillator (ICD) in the Multicenter Automatic Defibrillator Implantation Trial‐II. Compared with patients who had quit smoking before study entry (past smokers) and patients who had never smoked (never smokers), patients who continued smoking (current smokers) were significantly younger and generally had more favorable baseline clinical characteristics. Despite this, the adjusted hazard ratio (HR) for appropriate ICD therapy for fast ventricular tachycardia (at heart rates ≥180 b.p.m) or ventricular fibrillation was highest among current smokers (HR = 2.11 [95% CI 1.11–3.99]) and intermediate among past smokers (HR = 1.57 [95% CI 0.95–2.58]), as compared with never smokers (P for trend = 0.02). Current smokers also exhibited a higher risk of inappropriate ICD shocks (HR = 2.93 [95% CI 1.30–6.63]) than past (HR = 1.91 [95% CI 0.97–3.77]) and never smokers (P for trend = 0.008). Conclusions: In patients with ischemic left ventricular dysfunction, continued cigarette smoking is associated with a significant increase in the risk of life‐threatening ventricular tachyarrhythmias and inappropriate ICD shocks induced by rapid supraventricular arrhythmias. Our findings stress the importance of complete smoking cessation in this high‐risk population.

Từ khóa


Tài liệu tham khảo

10.1056/NEJMoa013474

10.1016/S0735-1097(01)01195-0

10.1016/0735-1097(95)00328-2

10.1161/01.CIR.87.1.76

10.1161/01.CIR.0000150390.04704.B7

10.1161/CIRCULATIONAHA.104.526673

10.1056/NEJM197806082982302

10.1161/01.CIR.93.11.2033

10.1056/NEJM198512123132404

10.1016/S0140-6736(74)92214-4

10.1136/hrt.43.4.463

10.2165/00003495-198400281-00002

10.1093/oxfordjournals.aje.a113960

10.1161/01.CIR.91.6.1749

10.1016/S0895-4356(99)00044-X

10.1056/NEJM198601303140502

10.1016/0002-9149(84)90183-8

10.1161/01.CIR.76.1.6

10.1161/01.CIR.60.4.752

10.1016/S0735-1097(84)80344-7

10.1016/S0735-1097(84)80058-3

10.1056/NEJM198911233212102

10.1177/107424849700200407

10.1097/00019501-199408000-00007

10.1001/archinte.163.19.2301

Thông tin
Thông tin xuất bản

Journal of Cardiovascular Electrophysiology

Tập 17 Số 9

931-936

Thông tin tác giả