0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Incidence of Loss of Consciousness during Automatic Implantable Cardioverter-Defibrillator Shocks

William H. Kou, MD; Hugh Calkins, MD; Ruth R. Lewis, MS, RN; Steve F. Bolling, MD; Marvin M. Kirsch, MD; Jonathan J. Langberg, MD; Michael de Buitleir, MD; Joao Sousa, MD; Rafel El-Atassi, MD; and Fred Morady, MD
[+] Article and Author Information

Requests for Reprints: William H. Kou, MD, Section of Cardiology (111A), Veterans Affairs Medical Center, 2215 Fuller Road, Ann Arbor, MI 48105.

Current Author Addresses: Dr. Kou: Section of Cardiology (111A), Veterans Affairs Medical Center, 2215 Fuller Road, Ann Arbor, MI 48105.

Drs. Calkins, Langberg, de Buitleir, Sousa, El-Atassi, and Morady and Ms. Lewis: Division of Cardiology, University of Michigan Hospital, 1500 East Medical Center Drive, Ann Arbor, MI 48109.

Drs. Bolling and Kirsch: Division of Thoracic Surgery, University of Michigan Hospital, 1500 East Medical Center Drive, Ann Arbor, MI 48109.


Ann Intern Med. 1991;115(12):942-945. doi:10.7326/0003-4819-115-12-942
Text Size: A A A

Objective: To determine the incidence of loss of consciousness occurring in association with shocks delivered by automatic implantable cardioverter-defibrillators (AICD) in patients who had undergone implantation as treatment for ventricular tachycardia or ventricular fibrillation.

Design: Cohort study.

Setting: Two major tertiary medical care facilities.

Patients: A total of 180 patients who had undergone implantation of an AICD for treatment of ventricular tachycardia or ventricular fibrillation.

Intervention: Implantation of an AICD that delivered only high-energy shock.

Measurements: During a mean (± SD) follow-up period of 16 ± 12 months, the incidence of loss of consciousness occurring in association with spontaneous AICD shocks was determined. Various clinical factors were analyzed to identify predictors of loss of consciousness that occurred during AICD shocks.

Main Results: Of the 180 patients who received an AICD, 106 patients (59%) experienced AICD shocks during follow-up. Sixteen of the 180 patients (9%) experienced loss of consciousness; 13 of these 16 patients had syncope and 3 died suddenly, in association with AICD shocks. The absence of syncope during one AICD shock did not always predict the absence of syncope during subsequent shocks. Syncope could not be predicted by age, sex, history of syncope, left ventricular function, type of underlying heart disease, electrophysiologic findings, rate of ventricular tachycardia, antiarrhythmic medications, and type of pulse generator implanted.

Conclusions: Patients with sustained ventricular tachycardia or ventricular fibrillation who receive an AICD that delivers only high-energy shock therapy are at moderate risk for experiencing loss of consciousness during AICD shocks. No clinical variables were found to be predictors of syncope. Therefore, driving and other activities that require patients to be extra vigilant should not be assumed to be safe after implantation of an AICD that delivers only high-energy shock.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Journal Club
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)