Atrial therapies reduce atrial arrhythmia burden in defibrillator patients
| Autor: | Stephen C. Hammill, Rahul Mehra, M S Stanton, Paul A. Friedman, B Dijkman, Eduardo N. Warman, H A Xia |
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| Rok vydání: | 2001 |
| Předmět: |
Tachycardia
Male medicine.medical_specialty Heart disease Defibrillation medicine.medical_treatment Cardioversion Physiology (medical) Multicenter trial Internal medicine Atrial Fibrillation medicine Humans Aged Fibrillation business.industry Atrial fibrillation Equipment Design Middle Aged medicine.disease Defibrillators Implantable Treatment Outcome Anesthesia Cardiology Tachycardia Ventricular Female medicine.symptom Cardiology and Cardiovascular Medicine business Atrial flutter Follow-Up Studies |
| Zdroj: | Circulation. 104(9) |
| ISSN: | 1524-4539 |
| Popis: | Background Approximately 25% of patients who receive an implantable cardioverter-defibrillator (ICD) to treat ventricular tachyarrhythmias have documented atrial tachyarrhythmias before implantation. This study assessed the ability of device-based prevention and termination therapies to reduce the burden of spontaneous atrial tachyarrhythmias. Methods and Results Patients with a standard indication for the implantation of an ICD and 2 episodes of atrial tachyarrhythmias in the preceding year received a dual-chamber ICD (Medtronic 7250 Jewel AF) that uses pacing and shock therapies for prevention and/or termination of atrial tachyarrhythmias. In a multicenter trial, patients were randomized to 3-month periods with atrial therapies “on” or “off” and subsequently crossed over. Analysis was performed on the 52 of 269 patients who had episodes of atrial tachyarrhythmia and had ≥30 days of follow-up with atrial therapies on and off. The atrial therapies resulted in a reduction of atrial tachyarrhythmia burden from a mean of 58.5 to 7.8 h/mo. A paired analysis (Wilcoxon signed-rank test) showed that the median difference in burden (1.1 h/mo) was highly significant ( P =0.007). When the subgroup of 41 patients treated only with atrial pacing therapies was analyzed, the reduction in burden persisted ( P =0.01). Conclusions In this study, patients with a standard ICD indication and atrial tachyarrhythmias had a significant reduction in atrial tachyarrhythmia burden with use of atrial pacing and shock therapies. |
| Databáze: | OpenAIRE |
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