Impact of Dual Chamber Pacing on the Incidence of Atrial and Ventricular Tachyarrhythmias in Recipients of Implantable Cardioverter Defibrillators

Autor:	Johann Mermi, Antonio Asso Abadia, Bernhard Strohmer, Harald Mayr, Christian Wolpert, Eduardo Castellanos, Martin Kuehl, Jaswinder Gill
Rok vydání:	2005
Předmět:	Male Tachycardia Pacemaker Artificial medicine.medical_specialty Ventricular Tachyarrhythmias medicine.medical_treatment Population Internal medicine Humans Medicine Heart Atria Prospective Studies education Prospective cohort study Aged education.field_of_study business.industry Incidence Incidence (epidemiology) Equipment Design General Medicine Implantable cardioverter-defibrillator Defibrillators Implantable Icd implantation Surgery Multicenter study Multivariate Analysis Tachycardia Ventricular Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business
Zdroj:	Pacing and Clinical Electrophysiology. 28:S249-S254
ISSN:	1540-8159 0147-8389
DOI:	10.1111/j.1540-8159.2005.00002.x
Popis:	Recent observations suggest that frequent dual-chamber pacing in recipients of implantable cardioverter defibrillators (ICD) may adversely influence clinical outcomes. This prospective, multicenter study examined the relationship between the frequency of atrial (%AP) and ventricular pacing (%VP) and the incidence of atrial (AT) and/or ventricular tachyarrhythmias (VT) in a standard ICD population. A total of 141 consecutive patients with primary and secondary ICD indications were studied. Continuous arrhythmia detection with a dual-chamber ICD revealed paroxysmal AT in 60 (43%) and VT in 72 (51%) patients within 6 months of device implantation. Far-field oversensing of ventricular signals occurred in 13% of all "atrial tachy response" mode switches. Without adjustment for covariates, a higher %AP was associated with an increased incidence of AT (P0.05). However, this association remained only weakly significant after adjustment for covariates using a multivariate model. High New York heart failure functional classes correlated significantly with AT (P = 0.02) and VT (P = 0.007). Rate-modulated pacing, programmed in 1/3 of patients, correlated with occurrence of AT (P = 0.006), but not with occurrence of VT. With respect to dual-chamber pacing, a %AP/= 48% combined with a %VP40% was associated with an increased probability for VT. In conclusion, AT and VT occurred frequently within 6 months after dual-chamber ICD implantation. High rates of DDD/R stimulation were associated with a trend toward higher incidence of AT, VT, or both.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dc2a86e2d11fb743c15402bc121f8c47 https://doi.org/10.1111/j.1540-8159.2005.00002.x Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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