When it comes to heart disease, many studies show that married patients are less likely to experience bad outcomes. New research presented last month at the American Heart Association (AHA) annual meeting suggests that this rings true for patients with an implantable cardioverter defibrillator or ICD – a device designed to prevent sudden cardiac death.
In the study, led by Mehmet Aktas, M.D., associate professor of Cardiology at the University of Rochester Medical Center, married ICD patients had a 39 percent lower risk of death when compared to unmarried patients. Married patients were more likely to be men and all patients were followed for more than five years.
When asked to explain this phenomenon, Wojciech Zareba, M.D., Ph.D., director of the Heart Research Follow-up Program and an international expert on the research and treatment of sudden cardiac death and other electrical disturbances of the heart, said individuals who are married have a built-in caregiver. “Patients who have a spouse living with them may be better taken care of; they may be more likely to take their medications and to attend follow-up appointments, which can lead to better outcomes.”
Zareba added that future research will examine female versus male ICD patients to better determine how gender influences outcomes.
This and 11 other studies were presented by members of the Heart Research Follow-up Program team at the AHA annual meeting. Research fellow Yitschak Biton, M.D., identified several risk factors – 65 years or older, past coronary artery bypass graft surgery, diminished ability of the heart to pump blood throughout the body, and others – that predict long-term survival in mild heart failure patients treated with CRT-D therapy (cardiac resynchronization therapy plus defibrillator). Patients with one or two of these risk factors survived longer when they received CRT-D therapy, as opposed to ICD therapy. In contrast, lower-risk patients with no risk factors, and higher-risk patients with three or more risk factors, did not survive any longer with CRT-D therapy.
CRT-D therapy combines an ICD, which senses dangerous abnormal heart rhythms and attempts to shock the heart back into a normal rhythm, with cardiac resynchronization therapy (CRT), which coordinates the beating of the heart so it can pump blood throughout the body more effectively. According to Zareba, Biton’s research will help physicians determine which patients are the best candidates for CRT-D therapy.
Other research included studies on the genetic underpinnings of inherited arrhythmic disorders like Long QT syndrome, rare disorders that makes the heart particularly susceptible to irregular rhythms, and arrhythmogenic ventricular cardiomyopathies, a group of heart muscle disorders that account for up to 20 percent of cases of sudden death in young people.