Rytmihäiriölääkityksen keskeyttämisen ja runsaan alkoholin käytön esiintyvyys rytmihäiriötahdistinhoidoissa

The aim of this study was to assess the prevalence of modifiable predisposing factors among patients under remote monitoring that received antitachycardia pacing or shock therapy. The examined risk factors were noncompliance to medication and excessive alcohol consumption. The study examined patients that were in remote monitoring in Helsinki University Hospital Heart and Lung Center and had received ICD or CRT-D therapy during the follow-up period from 1.1.2023 to 30.4.2024. A total of 1768 patients were under remote monitoring, of whom 157 (8.9 %) received device therapy. A nurse contacted the patients after each device therapy and collected information about medication and substance use. 23 (15 %) patients had a modifiable predisposing factor present in the index event. In 15 (65%) of these cases, this was due to cessation of antiarrhythmic therapy, five (22 %) involved excessive alcohol use and three (13 %) involved both. The patients with predisposing factors were significantly younger than those without them (56.6 vs. 64.1 years, p = 0.001). Of all the recurrent therapies, predisposing factors were present in 11 (13 %) patients, and five patients had a recurrent event due to the same predisposing factor. Modifiable predisposing factors were present in one out of six patients with ventricular arrhythmia requiring device therapy. Our observational data do not prove a causal relationship between the predisposing factors and device therapy, as predisposing factors were not assessed in the whole ICD/CRT-D cohort. However, the results support guidance of patients to minimize alcohol consumption and comply with prescribed medication. In addition, our results indicate that in our cohort predisposing factors were relatively common.