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

News | Heart Failure| October 02, 2015
Cyberonics Inc. announced results from the extension of the ANTHEM-HF clinical study (ENCORE Study). Results of the...
Tryton Side Branch Stent, clinical trial results, Catheterization and Cardiovascular Interventions

Tryton Side Branch Stent image courtesy of Tryton Medical

News | Stents Bifurcation| October 02, 2015
October 2, 2015 — Tryton Medical Inc.
AtriCure, cryoFORM cryoablation probe, launch
Technology | Ablation Systems| October 02, 2015
AtriCure Inc. launched the cryoFORM cryoablation probe, which offers increased probe flexibility to adapt to a variety...
Intact Vascular, TOBA II study, Tack Endovascular System

Image courtesy of Intact Vascular

News | Peripheral Arterial Disease (PAD)| October 01, 2015
Intact Vascular Inc. announced the U.S. Food and Drug Administration has granted conditional approval for a U.S. and...
Johns Hopkins, sticky gel, stem cells, rat hearts, heart attacks

Hydrogel applied to beating rat hearts improves stem cell uptake by the heart muscle and speeds up tissue healing after heart attack. Image courtesy of Johns Hopkins Medicine.

News | Stem Cell Therapies| September 29, 2015
A sticky, protein-rich gel created by Johns Hopkins researchers appears to help stem cells stay on or in rat hearts and...
News | Cath Lab| September 29, 2015
The Innovation Institute announced that Boston Scientific has signed an agreement to become the founding medical device...
Eluvia drug-eluting vascular stent system, 12-month primary patency, Boston Scientific, MAJESTIC trial, CIRSE

Image courtesy of Boston Scientific

News | Stents Peripheral| September 28, 2015
New 12-month clinical trial outcomes assessing the safety and performance of the Boston Scientific Eluvia drug-eluting...
predicting arrhythmias, mcgill university, alternans patterns
News | EP Lab| September 28, 2015
Researchers have discovered how to predict some cardiac arrhythmias several steps before they even occur. It’s a...
News | Antiplatelet and Anticoagulation Therapies| September 25, 2015
The Icahn School of Medicine at Mount Sinai has launched the international TWILIGHT clinical trial to test the safety...
Medisafe, medication management, mHealth platform, blood pressure study, hypertension, adherence
News | Hypertension| September 25, 2015
Medisafe, an mHealth platform for medication management, announced the results of its blood pressure study, which...
Overlay Init