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    Gender Differences and Demographics and Type of Cardiac Device over a 10-Year Period
    (Medknow Publications & Media Pvt Ltd, 2018) Aktoz, M.; Ucar, M. F.; Yilmaztepe, M. A.; Taylan, G.; Altay, S.
    Aims: This study aims to review the influence of gender-specific differences and patient demographics on cardiac device and pacing mode selection over a 10-year period. Methods: We retrospectively reviewed patients who underwent first implantation of the cardiac device between January 1, 2006 and June 31, 2016. Results: During the study period, 704 patients underwent first cardiac device implantation. Number of patients undergoing pacemaker was 452 and number of patients undergoing implantable cardioverter defibrillator/cardiac resynchronization therapy and defibrillator (ICD/CRT-D) was 252. Patients undergoing pacemaker were 49.9% female with mean age 72.36+11.1. The most common indication was atrioventricular block (AVB) (84%) in both genders. The most frequently used pacing modes were VVI (70.8%), but over a 10-year period pacemaker selection shifted from VVI to DDD pacemakers. Patients undergoing ICD/CRT-D were 19.7% female with mean age 62.5+10.8. The most common indications for ICD/CRT-D was ischemic cardiomyopathy (ICMP) (55.0%). The rate of male patients was higher in patients who have received device therapy for dilated cardiomyopathy (DCMP) or ICMP, whereas the rate of female patients was higher in hypertrophic cardiomyopathy (HCMP) patients. The most common used implanted system was VVI-ICD (60.6%). Conclusions: The present study demonstrated that there was no significant difference between female and male patients in pacing mode selection, mostly VVI pacing mode was chosen; however, over a 10-year period pacemaker selection shifted from VVI to DDD pacemakers. Female patients had less ICD/CRT-D implantation than male patients.
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    ICD detected patient activity is associated with arrhythmic events in heart failure patients
    (Wolters Kluwer Medknow Publications, 2020) Ucar, F. M.; Yilmaztepe, M. A.
    Background: Although implantable cardioverter-defibrillator (ICD) reduces mortality in heart failure patients with reduced left ventricle function, arrhythmic episodes are related with increased mortality. Aim: The aim of this study was to investigate whether low patient activity predicts arrhythmic events in the heart failure patients with primary prevention ICD. Methods: We examined 206 heart Failure (HF) patients (mean age: 61.3 +/- 10.9 years, 77.7% male) with primary prevention implanted ICD who referred to our outpatient clinic for pacemaker control. After pacemaker (PM) controls, the overall study group was categorized into three distinct subgroups: Activity less than 2 h, activity 2-4 h, and activity 4-8 h in a day. Results: Activity less than 2 h had a substantially higher level of arrhythmic episodes in comparison to other groups (P < 0.05). In addition, appropriate shock or ATP (antitachycardia pacing) was detected higher in patients whose activity was less than 2 h in a day than other groups (P < 0.001). Conclusions: Detected low patient activity in ICD control may be a predictor of arrhythmic episodes and appropriate therapies. Increasing physical activity may potentially protect these patients from unwanted events.