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Kidney disease increases risk of sudden cardiac death for ICD patients

September 19, 2006

End-stage kidney disease significantly increases the risk of life-threatening heart rhythm abnormalities in patients with implantable cardioverter defibrillators (ICDs), according to a study published in the October 2006 edition of Heart Rhythm. However, compared to ICD patients without kidney disease, patients with end-stage renal disease (ESRD) survived less than half as many years (3.2 years vs. 7.4 years, respectively) despite being implanted with a cardiac device.

"The study calls into question the survival benefit of ICDs in patients with this degree of kidney disease who meet current implant indications," said Dr. Rod Passman, M.D., M.S.C.E., a cardiac electrophysiologist and epidemiologist at Northwestern University School of Medicine and senior author of the study. "Continued research is needed to determine what can be done to prevent sudden death due to abnormal heart rhythms in patients with ESRD and to determine which ESRD patients can benefit from ICD therapy."

The study was conducted at Northwestern Memorial Hospital and involved 585 patients with and without ESRD prior to ICD implantation and was the first to identify kidney disease as a risk factor for appropriate ICD therapy. Therapy occurs when the device delivers a shock to terminate ventricular fibrillation or ventricular tachycardia, rhythms that may be fatal if left untreated.

More than half a million people have ESRD, which occurs when the kidneys fail to excrete harmful wastes and, as a result, causes the body to retain fluid, potassium, and other toxins. Sudden cardiac death is often the result of rapid and chaotic heart rhythms in the bottom chambers of the heart and is the most frequent cause of death in people with ESRD, though the exact cause is not fully understood.

GYMR

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