Author + information
- Mohammad Madjida,b,
- Allison T. Connollya,b,
- Yelena Nabutovskya,b,
- Payam Safavi-Naeinia,b and
- Charles C. Millera,b
Background: Influenza increases the risk of cardiovascular events. We investigated the effect of influenza epidemic on the risk of ventricular arrhythmia (VA)s and VA therapies in patients with implantable cardiac defibrillators (ICD) and cardiac resynchronization therapy defibrillators (CRT-D).
Methods: We studied 170,921 pts with an ICD or a CRT-D in the St. Jude Medical Merlin.net remote monitoring network between Jan 2009 and May 2016. Flu epidemics were defined as region-specific weeks when percent-positive flu-like-illness specimens exceeded 6%. Outcomes included the odds of a VA with shock(s), with anti-tachycardia pacing (ATP), or without therapy. We utilized a general linear model adjusted for within-patient effects, age, gender, and device type.
Results: Flu epidemics increased the risk of VA with and without therapy. The risk of VA was influenced by specific months, gender, and age. Risk of shock was especially elevated by flu epidemics in February (OR=1.27). Risk of VA with ATP and without therapy was highest in patients 75 yrs or older. Patients who received shocks were more likely to receive them during flu epidemics from Feb to May (OR=1.45 in Feb, 95% CI=1.25-1.68, p<0.01).
Conclusions: Influenza epidemics had a modest but significant effect on the risk of VA, with an equivalent risk for VAs requiring ATP or shock. Winter months and older age present the largest risk of VA associated with flu epidemics. Efforts should be made to maximize influenza vaccination and treatment in such patients.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Current Issues in Cardiovascular Epidemiology, Disparities, and Safety
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1148-045
- 2017 American College of Cardiology Foundation