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.
J Cardiovasc Electrophysiol
; 31(4): 846-853, 2020 04.
Article
em En
| MEDLINE
| ID: mdl-32064713
ABSTRACT
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 ANDRESULTS:
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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
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Taquicardia Supraventricular
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Cardioversão Elétrica
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Função Atrial
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Desfibriladores Implantáveis
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Técnicas Eletrofisiológicas Cardíacas
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Insuficiência Cardíaca
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Cardiomiopatias
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
J Cardiovasc Electrophysiol
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Itália