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

radiation dose in the cath lab
News | Radiation Dose Management| May 02, 2016
May 2, 2016 — Starting at the Society for Cardiovascular Angiography and Interventions (SCAI) 2016 annual meeting May
AtriCure, AtriClip PRO2 LAA Exclusion System, left atrial appendage, FDA clearance
Technology | Left Atrial Appendage (LAA) Occluders| April 29, 2016
April 29, 2016 — AtriCure Inc. announced U.S.
microtubules, heartbeat mechanics, Perelman School of Medicine study

Microtubules in a cardiomyocyte at rest (top) and when compressed. Image courtesy of the lab of Ben Prosser, Ph.D., Perelman School of Medicine, University of Pennsylvania

News | EP Lab| April 29, 2016
Using new high-resolution microscopy, researchers have found that molecular struts called microtubules (MT) interact...
Boston Scientific, FDA, ImageReady MR-Conditional Pacing System
Technology | EP Lab| April 28, 2016
Boston Scientific has received U.S. Food and Drug Administration (FDA) approval for a suite of products deemed safe for...
breast cancer, herceptin chemotherapy drug, heart damage, monitoring, Journal of Clinical Oncology study
News | Cardiac Diagnostics| April 28, 2016
April 28, 2016 — Breast cancer patients undergoing treatment with trastuzumab-containing regimens should be monitored
Feature | Business| April 28, 2016 | Dave Fornell
 
coronary CT angiography, CCTA, SCOT-HEART trial substudy, SCCT
News | Computed Tomography (CT)| April 26, 2016
The results of a secondary analysis of the SCOT-HEART trial show that coronary computed tomography angiography (CCTA)...
sleep patterns, metabolic syndrome, risk factors, ACC study
News | Cardiac Diagnostics| April 26, 2016
Taking long naps or being excessively tired during the day is associated with a higher risk for developing metabolic...
Auris Surgical Robotics, acquisition, Hansen Medical
News | Robotic Systems| April 26, 2016
Auris Surgical Robotics Inc. and Hansen Medical Inc. announced that they have signed a definitive merger agreement...
CABG, bypass surgery, heart failure, NHLBI study
News | Cardiovascular Surgery| April 25, 2016
Scientists have found that a greater number of patients with coronary artery disease may benefit from coronary artery...
Overlay Init