Clinical Course of Dual-Chamber Implantable Cardioverter-Defibrillator Recipients followed by Cardiac Remote Monitoring: Insights from the LION Registry

Autor: Wolfgang R. Bauer, Andreas Lang, Hanno Oswald, Tino Hauser, Joerg O. Schwab, Paul Korb, Oliver Gunkel, Herbert Nägele, Gunnar Klein
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Tachycardia
Male
medicine.medical_specialty
Article Subject
medicine.medical_treatment
Population
lcsh:Medicine
030204 cardiovascular system & hematology
General Biochemistry
Genetics and Molecular Biology
03 medical and health sciences
0302 clinical medicine
Statistical significance
Internal medicine
medicine
Humans
In patient
030212 general & internal medicine
Heart Atria
cardiovascular diseases
education
Adverse effect
Aged
Monitoring
Physiologic
Heart Failure
education.field_of_study
General Immunology and Microbiology
business.industry
lcsh:R
Clinical course
Cardiac Pacing
Artificial
Arrhythmias
Cardiac
General Medicine
Middle Aged
medicine.disease
Implantable cardioverter-defibrillator
Defibrillators
Implantable
Heart failure
Remote Sensing Technology
Cardiology
Tachycardia
Ventricular
cardiovascular system
Female
medicine.symptom
business
Research Article
Zdroj: BioMed Research International, Vol 2018 (2018)
BioMed Research International
ISSN: 2314-6141
2314-6133
Popis: Patients receiving dual-chamber implantable cardioverter-defibrillator (DR-ICD) therapy are at risk of developing atrial arrhythmia because of the increased rate of ventricular pacing and the progression of heart failure. Remote monitoring (RM) may identify the patients at highest risk of adverse events such as atrial arrhythmias. A total of 283 patients with 91,632 remote transmissions during a 15-month follow-up (FU) period enrolled in the LION registry were analysed. The parameters retrieved included the pacing mode, lower rate limit, percentage of atrial (%AP) and ventricular pacing (%VP), and percentage of atrial arrhythmia burden (%AB). In 92.7% of patients, the devices were initially programmed in DDD(R) or DDI(R), with changes of the pacing mode in 19.3% only. The lower rate limit remained stable in 80.4% of patients. At the first transmission, 8.7% of patients suffered from RM-detected atrial arrhythmia, which reached 36% during FU. The %AP was not associated with increased AB (p = 0.67), but the %VP was different in patients developing RM-detected atrial arrhythmia (26.9% vs. 13.7%, p < 0.00001). The %VP increased in 105 patients (significance level of α = 0.05), and 11 patients crossed the border of 50% VP. The LION substudy supports the concept of using RM in a real-world DR-ICD population. Remote monitoring of DR-ICDs allows for the quantification of the course of the pacing parameters and AB. Based on these observations, device parameters can be adjusted and optimized.
Databáze: OpenAIRE
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