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Clinical Implications of Brief Device-Detected Atrial Tachyarrhythmias in a Cardiac Rhythm Management Device Population: Results from the Registry of Atrial Tachycardia and Atrial Fibrillation Episodes.
Swiryn, Steven; Orlov, Michael V; Benditt, David G; DiMarco, John P; Lloyd-Jones, Donald M; Karst, Edward; Qu, Fujian; Slawsky, Mara T; Turkel, Melanie; Waldo, Albert L.
Afiliação
  • Swiryn S; From the Feinberg School of Medicine, Northwestern University, Chicago, IL (S.S., D.M.L.-J.; Tufts University School of Medicine, Boston, MA (M.V.O.); University of Minnesota Medical School, Minneapolis (D.G.B.); University of Virginia, Charlottesville (J.P.D.); St. Jude Medical, Sunnyvale, CA (E.K.
  • Orlov MV; From the Feinberg School of Medicine, Northwestern University, Chicago, IL (S.S., D.M.L.-J.; Tufts University School of Medicine, Boston, MA (M.V.O.); University of Minnesota Medical School, Minneapolis (D.G.B.); University of Virginia, Charlottesville (J.P.D.); St. Jude Medical, Sunnyvale, CA (E.K.
  • Benditt DG; From the Feinberg School of Medicine, Northwestern University, Chicago, IL (S.S., D.M.L.-J.; Tufts University School of Medicine, Boston, MA (M.V.O.); University of Minnesota Medical School, Minneapolis (D.G.B.); University of Virginia, Charlottesville (J.P.D.); St. Jude Medical, Sunnyvale, CA (E.K.
  • DiMarco JP; From the Feinberg School of Medicine, Northwestern University, Chicago, IL (S.S., D.M.L.-J.; Tufts University School of Medicine, Boston, MA (M.V.O.); University of Minnesota Medical School, Minneapolis (D.G.B.); University of Virginia, Charlottesville (J.P.D.); St. Jude Medical, Sunnyvale, CA (E.K.
  • Lloyd-Jones DM; From the Feinberg School of Medicine, Northwestern University, Chicago, IL (S.S., D.M.L.-J.; Tufts University School of Medicine, Boston, MA (M.V.O.); University of Minnesota Medical School, Minneapolis (D.G.B.); University of Virginia, Charlottesville (J.P.D.); St. Jude Medical, Sunnyvale, CA (E.K.
  • Karst E; From the Feinberg School of Medicine, Northwestern University, Chicago, IL (S.S., D.M.L.-J.; Tufts University School of Medicine, Boston, MA (M.V.O.); University of Minnesota Medical School, Minneapolis (D.G.B.); University of Virginia, Charlottesville (J.P.D.); St. Jude Medical, Sunnyvale, CA (E.K.
  • Qu F; From the Feinberg School of Medicine, Northwestern University, Chicago, IL (S.S., D.M.L.-J.; Tufts University School of Medicine, Boston, MA (M.V.O.); University of Minnesota Medical School, Minneapolis (D.G.B.); University of Virginia, Charlottesville (J.P.D.); St. Jude Medical, Sunnyvale, CA (E.K.
  • Slawsky MT; From the Feinberg School of Medicine, Northwestern University, Chicago, IL (S.S., D.M.L.-J.; Tufts University School of Medicine, Boston, MA (M.V.O.); University of Minnesota Medical School, Minneapolis (D.G.B.); University of Virginia, Charlottesville (J.P.D.); St. Jude Medical, Sunnyvale, CA (E.K.
  • Turkel M; From the Feinberg School of Medicine, Northwestern University, Chicago, IL (S.S., D.M.L.-J.; Tufts University School of Medicine, Boston, MA (M.V.O.); University of Minnesota Medical School, Minneapolis (D.G.B.); University of Virginia, Charlottesville (J.P.D.); St. Jude Medical, Sunnyvale, CA (E.K.
  • Waldo AL; From the Feinberg School of Medicine, Northwestern University, Chicago, IL (S.S., D.M.L.-J.; Tufts University School of Medicine, Boston, MA (M.V.O.); University of Minnesota Medical School, Minneapolis (D.G.B.); University of Virginia, Charlottesville (J.P.D.); St. Jude Medical, Sunnyvale, CA (E.K.
Circulation ; 134(16): 1130-1140, 2016 10 18.
Article em En | MEDLINE | ID: mdl-27754946
ABSTRACT

BACKGROUND:

The RATE Registry (Registry of Atrial Tachycardia and Atrial Fibrillation Episodes) is a prospective, outcomes-oriented registry designed to document the prevalence of atrial tachycardia and/or fibrillation (AT/AF) of any duration in patients with pacemakers and implantable cardioverter defibrillators (ICDs) and evaluate associations between rigorously adjudicated AT/AF and predefined clinical events, including stroke. The appropriate clinical response to brief episodes of AT/AF remains unclear.

METHODS:

Rigorously adjudicated electrogram (EGM) data were correlated with adjudicated clinical events with logistic regression and Cox models. Long episodes of AT/AF were defined as episodes in which the onset and/or offset of AT/AF was not present within a single EGM recording. Short episodes of AT/AF were defined as episodes in which both the onset and offset of AT/AF were present within a single EGM recording.

RESULTS:

We enrolled 5379 patients with pacemakers (N=3141) or ICDs (N=2238) at 225 US sites (median follow-up 22.9 months). There were 359 deaths. There were 478 hospitalizations among 342 patients for clinical events. We adjudicated 37 531 EGMs; 50% of patients had at least one episode of AT/AF. Patients with clinical events were more likely than those without to have long AT/AF (31.9% vs. 22.1% for pacemaker patients and 28.7% vs. 20.2% for ICD patients; P<0.05 for both groups). Only short episodes of AT/AF were documented in 9% of pacemaker patients and 16% of ICD patients. Patients with clinical events were no more likely than those without to have short AT/AF (5.1% vs. 7.9% for pacemaker patients and 11.5% vs. 10.4% for ICD patients; P=0.21 and 0.66, respectively).

CONCLUSIONS:

In the RATE Registry, rigorously adjudicated short episodes of AT/AF, as defined, were not associated with increased risk of clinical events compared with patients without documented AT/AF. CLINICAL TRIAL REGISTRATION URL http//www.clinicaltrials.gov. Unique identifier NCT00837798.
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Base de dados: MEDLINE Assunto principal: Marca-Passo Artificial / Taquicardia / Desfibriladores Implantáveis Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged País como assunto: America do norte Idioma: En Ano de publicação: 2016 Tipo de documento: Article
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Base de dados: MEDLINE Assunto principal: Marca-Passo Artificial / Taquicardia / Desfibriladores Implantáveis Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged País como assunto: America do norte Idioma: En Ano de publicação: 2016 Tipo de documento: Article