The role of atrial sensing for new-onset atrial arrhythmias diagnosis and management in single-chamber implantable cardioverter-defibrillator recipients: Results from the THINGS registry
| Autor: | V. Carinci, Angelo Placci, Matteo Iori, G Statuto, Valeria Calvi, D Grassini, Davide Saporito, Matteo Ziacchi, Giulio Boggian, Maria Giulia Bolognesi, Mauro Biffi, Daniele Giacopelli, Elia De Maria, Ernesto Ammendola, Giuseppe Allocca |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Supraventricular Time Factors medicine.medical_treatment Administration Oral 030204 cardiovascular system & hematology 0302 clinical medicine anticoagulation atrial dipole atrial fibrillation atrial high-rate episode implantable cardioverter-defibrillator Aged Anti-Arrhythmia Agents Anticoagulants Atrial Fibrillation Cardiomyopathies Catheter Ablation Electric Countershock Electrophysiologic Techniques Cardiac Female Heart Failure Humans Incidence Middle Aged Predictive Value of Tests Prospective Studies Prosthesis Design Registries Tachycardia Supraventricular Treatment Outcome Atrial Function Defibrillators Implantable Tachycardia Medicine 030212 general & internal medicine Incidence (epidemiology) Hazard ratio Atrial fibrillation Implantable cardioverter-defibrillator Administration Cardiology Electrophysiologic Techniques medicine.symptom Implantable Cardiology and Cardiovascular Medicine Cardiac Oral medicine.medical_specialty 03 medical and health sciences Physiology (medical) Internal medicine Atrial tachycardia Fibrillation business.industry Atrial arrhythmias medicine.disease Confidence interval business Defibrillators |
| Popis: | INTRODUCTION Atrial tachycardia/fibrillation (AT/AF) episodes are common in implantable cardioverter-defibrillator (ICD) recipients and can be undetected by standard single-chamber devices. This study aims to explore whether a single-lead ICD with an atrial dipole (ICD DX; BIOTRONIK SE & Co, Berlin, Germany) could improve the AT/AF diagnosis and management as compared to standard ICD (ICD VR). METHODS AND RESULTS We selected patients without AT/AF history from the THINGS registry which included consecutive patients implanted with ICD for standard indications. The ICD VR and the ICD DX groups included 236 (62.8%) and 140 (37.2%) patients, respectively, and had no significant differences in baseline characteristics. During a median follow-up of 27 months, there were 7 AT/AF diagnoses in the ICD VR and 18 in the ICD DX group. The 2-year incidence of AT/AF diagnosis was 3.6% (95% confidence interval [CI]: 1.6%-9.6%) for the ICD VR and 11.4% (95% CI: 6.8%-18.9%) for the ICD DX group (adjusted hazard ratio [HR]: 3.85 [95% CI: 1.58-9.41]; P = .003). Initiation of oral anticoagulation (OAC) due to AT/AF diagnosis was reported in 15 patients. The 2-year incidence of OAC onset was 3.6% (95% CI: 1.6%-7.8%) for the ICD VR and 6.3% (95% CI: 3.0%-12.7%) for ICD DX group (adjusted HR: 1.99 [95% CI: 0.72-5.56]; P = .184). CONCLUSION We observed that atrial sensing capability in single-chamber ICD patients without evidence of atrial arrhythmias at implant is associated with a greater likelihood of detecting AT/AF episodes. The management of these diagnosed arrhythmias often led to clinical interventions, mainly represented by initiation of OAC therapy. |
| Databáze: | OpenAIRE |
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