Feature | March 11, 2013

Weight Loss Linked to Higher Risk With ICD Implants

Study suggests increased monitoring of patients with unplanned weight loss

Weight Loss American College of Cardiology ICD Implants Risk

March 11, 2013 — Even minor weight loss is associated with worse health outcomes among patients implanted with a certain type of implantable cardioveter defibrillator known as cardiac resynchronization therapy with defibrillator (CRT-D), according to research being presented at the American College of Cardiology’s 62nd Annual Scientific Session.

People with symptoms of heart failure who have an implantable CRT-D device may believe that losing weight will ultimately improve their long-term health outcomes. However, in the first study to look at weight loss and subsequent health outcomes among patients with a CRT-D, researchers found the opposite may be true.

“In patients with heart failure who receive a cardiac resynchronization device with defibrillator, unintended weight loss of just five pounds increases the risk of a serious cardiac event,” said Valentina Kutyifa, M.D., postdoctoral research associate at the University of Rochester Medical Center and the lead author of the Multicenter Automatic Defibrillator Implantation with Cardiac Resynchronization Therapy (MADIT-CRT) trial. “These findings suggest clinicians should be monitoring patients with unplanned weight loss more closely.”

Among the subset of patients who had a specific heart condition called a left bundle branch block, the risk of heart failure or death with weight loss doubled. CRT-D devices work by emitting small electronic impulses to coordinate the heart’s rhythm and improve the ability of the heart to pump blood in patients with heart failure, and by attempting to shock the heart back into a normal rhythm when dangerous heart rhythms are detected. CRT-Ds comprise one-third of all pacemakers.

In this study, nearly 1,000 patients who received a CRT-D were observed at 12 months after implantation. Of these, nearly one in five (17 percent) had lost more than 2 kilograms, or 4.4 pounds, during that time.

These patients had a significant increase in their risk of heart failure or death compared to those without significant weight loss. In fact, each kilogram (2.2 pounds) of weight lost correlated to a 4 percent higher risk of heart failure or death.

This study fits with other studies that have looked at the “obesity paradox,” wherein overweight patients with chronic diseases such as heart disease, kidney disease or diabetes, have better health outcomes than those of normal weight. One reason for this paradox among CRT-D patients might be that heart failure causes the body to be in a catabolic state, meaning it has a high demand for energy. Heart failure patients without significant weight loss may have reserves that better allow their bodies to tolerate this high-energy demand, Kutyifa said.

Study authors caution that their findings are not a prescription for patients to pack on the pounds. “We would still recommend weight control under a physician’s supervision since we know that obesity is associated with other serious diseases including diabetes, high blood pressure, coronary artery disease and sleep apnea,” Kutyifa said. “Heart failure patients should continue to follow their clinicians’ advice in regards to diet and lifestyle changes.”

According to Kutyifa, more research is needed to examine the effects of weight loss among heart failure patients with pacemakers in prospective clinical trials. The MADIT-CRT trial was supported by a research grant from Boston Scientific, St. Paul, Minn.

For more information: cardiosource.org

Related Content

CardioKinetix, Parachute device, Heart Failure device therapy

The CardioKinetix Parachute device implant shown deployed in the left ventricle or a heart failure patient. The device helps remodel the ventricle to improve the heart's ability to pump blood more efficiently. 

Feature | Heart Failure| September 29, 2016 | Abha Mishra
New cardiovascular device therapies for atrial fibrillation (AF) and heart failure (HF) are rapidly evolving with the
Infinix 4D CT

Toshiba's Infinix 4D CT, which combines CT with angiography in the interventional lab.

Feature | Angiography| September 28, 2016 | Tom Watson BS, RCVT, Clinical Analyst, MD Buyline
One of the more significant advancements for interventional X-ray (IXR) in the past few years has been a significantl
TCT 2016, TCT.16, main arena, late breaking trials
Feature | Cath Lab| September 28, 2016
September 28, 2016 — The Cardiovascular Research Foundation (CRF) has announced the 11 late-breaking trials and 16 fi
European Heart Rhythm Association, EHRA White Book 2016, EP Europace supplement, cardiac rhythm device use, Europe
News | EP Lab| September 27, 2016
In August, the European Heart Rhythm Association (EHRA) and EP Europace journal announced the release of the supplement...
News | Pharmaceuticals| September 26, 2016
Nearly 2 out of 5 people with diabetes who could benefit from statin therapy to lower their risk of future heart attack...
smartphones, hospital tranfers, heart attack patients, JACC study, South Korea
News | Mobile Devices| September 23, 2016
Smartphone communication among medical teams at different hospitals can significantly reduce the time it takes for...
Medtronic, In.Pact Admiral drug-coated balloon, trial data, VIVA
News | Drug-Eluting Balloons| September 22, 2016
New data presented at the Vascular Interventional Advances (VIVA) conference demonstrated the durability, consistency...
Sponsored Content | Videos | Inventory Management| September 21, 2016
With bundled payments putting increased pressure on hospitals to manage supply costs while providing quality patient
Medtronic, CRT, cardiac resynchroniazation therapy devices, heart failure, medication adherence, retrospective analysis, HFSA 2016
News | Heart Failure| September 20, 2016
Medtronic plc announced the results of an analysis that reveals patients increasingly adhere to heart failure...
Valtech Cardio, Cardioband Tricuspid, Cardioband Mitral, PCR London Valves 2016, study data
News | Heart Valve Technology| September 19, 2016
Valtech Cardio Ltd. announced that it will present the first-in-man data for its Cardioband Tricuspid (TR) system at...
Overlay Init