Frequency of Inappropriate Therapy in Patients Implanted with Dual- Versus Single-Chamber ICD Devices in the ICD Arm of MADIT-CRT

Autor:	Arthur J. Moss, Scott Mcnitt, Christian Jons, Wojciech Zareba, Nitesh Sood, Anne-Christine Ruwald, Martin H. Ruwald, Paul Wang, Christopher A. Clyne
Rok vydání:	2013
Předmět:	medicine.medical_specialty business.industry Proportional hazards model Incidence (epidemiology) medicine.medical_treatment Hazard ratio medicine.disease Implantable cardioverter-defibrillator Physiology (medical) Internal medicine Heart failure medicine Antitachycardia Pacing Cardiology In patient Cardiology and Cardiovascular Medicine Intensive care medicine business Single chamber
Zdroj:	Journal of Cardiovascular Electrophysiology. 24:672-679
ISSN:	1045-3873
DOI:	10.1111/jce.12099
Popis:	Inappropriate Therapy in Single Versus Dual Chamber Background The majority of implantable cardioverter defibrillators (ICDs) are dual-chamber devices, but studies on the frequency of inappropriate therapy in dual- versus single-chamber devices have shown conflicting results. The aim of this study is to determine whether implantation of dual-chamber ICD devices decrease the incidence of inappropriate therapy without an unacceptable increase in complications. Methods In the ICD arm of the MADIT-CRT study (N = 704), comparisons of single- versus dual-chamber ICD devices were investigated on the endpoints of inappropriate therapy (antitachycardia pacing [ATP] and shocks) and device- and procedure-related complications by use of multivariate Cox proportional hazard regression analysis (hazard ratio dual:single chamber) adjusting for relevant covariates. Results The frequency of inappropriate therapies in single- and dual-chamber recipients was 41/294 (14%) and 50/410 (12%), respectively. There was no significant difference in overall inappropriate therapy (hazard ratio [HR] = 0.95 [CI: 0.63–1.45], P = 0.95) or inappropriate ATP (HR = 0.98 [CI: 0.61–1.58], P = 0.94), between single- and dual-chamber devices, using single-chamber as a reference (Dual:Single). However, there was a trend toward a decrease in inappropriate shocks (HR = 0.60 [CI: 0.34–1.08], P = 0.09) in the dual-chamber group. The same was evident when only analyzing inappropriate therapy for atrial tachyarrhythmias (HR = 0.88 [CI: 0.56–1.38], P = 0.58). There was no significant difference between the groups in device- or procedure-related complications (HR = 1.54 [CI: 0.82–2.90], P = 0.18). Conclusion No significant difference was found in inappropriate therapy or complications in patients treated with single- versus dual-chamber ICD devices.
Databáze:	OpenAIRE
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