Electrical treatment of atrial arrhythmias in heart failure patients implanted with a dual defibrillator CRT device. Results from the TRADE-HF study.

Autor: Botto GL; Cardiology Dept., Sant'Anna Hopsital, S. Fermo Della Battaglia, Italy. Electronic address: gluca.botto@gmail.com., Padeletti L; Cardiology Dept., Careggi Hospital, University of Firenze, Firenze, Italy., Covino G; Cardiology Dept., S Giovanni Bosco Hospital, Napoli, Italy., Pieragnoli P; Cardiology Dept., Careggi Hospital, University of Firenze, Firenze, Italy., Liccardo M; Cardiology Dept., S. Maria delle Grazie Hospital, Pozzuoli, Italy., Mariconti B; Cardiology Dept., Sant'Anna Hopsital, S. Fermo Della Battaglia, Italy., Favale S; Cardiology Dept., Policlinico Consorziale Hospital, University of Bari, Bari, Italy., Molon G; Cardiology Dept., Sacro Cuore Hospital, Negrar, Italy., De Filippo P; Cardiology Dept., Ospedali Riuniti, Bergamo, Italy., Bolognese L; Cardiology Dept., S. Donato Hospital, Arezzo, Italy., Landolina M; Cardiology Dept., S. Matteo Hospital, Pavia, Italy and Ospedale Maggiore, Crema, Italy., Raciti G; Boston Scientific Corporation, United States., Boriani G; Cardiology Dept., DIMES Department, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy and Cardiology Division, Department of Diagnostics, Clinical and Public Health Medicine. University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2017 Jun 01; Vol. 236, pp. 181-186. Date of Electronic Publication: 2017 Jan 19.
DOI: 10.1016/j.ijcard.2017.01.101
Abstrakt: Background: Ventricular and atrial arrhythmias commonly occur in heart failure patients and are a significant source of symptoms, morbidity and mortality. Some specific generators referred to as dual defibrillators, Dual CRT-Ds, have the ability to treat atrial and ventricular arrhythmias. TRADE-HF is a prospective two-arm randomized study aimed at assessing the benefits of complete automatic management of atrial arrhythmias in patients implanted with a dual CRT-D.
Methods: Primary objective of the TRADE-HF study was to document reduction of unplanned hospital admission for cardiac reasons or death for cardiovascular causes or progression to permanent AF, by comparing fully-automatic device driven therapy for atrial tachycardia or fibrillation (AT/AF) to an in-hospital approach for treatment of symptomatic AT/AF. Randomized Patients were followed every 6months for 3years to assess the primary objective.
Results: Four-hundred-twenty patients have been enrolled in the study. At the end of the study 30 subjects died for cardiovascular causes, 60 had at least one hospitalization for cardiovascular causes and 14 developed permanent AF. Eighty-seven patients experienced a composite event. Hazard Ratio for device-managed automatic therapy arm compared to traditional was 0.987 (95% CI: 0.684-1.503; p=0.951). The primary endpoint analysis resulted in no difference between the device managed and in-hospital treatment arm.
Conclusion: The TRADE-HF study failed to demonstrate a reduction in the composite of unplanned hospitalizations for cardiovascular causes or death for cardiovascular causes or progression to permanent AF using automatic atrial therapy compared to a traditional approach including hospitalization for symptomatic episodes and/or in-hospital treatment of AT/AF.
(Copyright © 2017 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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