Bibliographic Details
| Title: |
Impact of Dual Chamber Pacing on the Incidence of Atrial and Ventricular Tachyarrhythmias in Recipients of Implantable Cardioverter Defibrillators. |
| Authors: |
STROHMER, BERNHARD1 (AUTHOR), MERMI, JOHANN2 (AUTHOR), CASTELLANOS, EDUARDO3 (AUTHOR), MAYR, HARALD4 (AUTHOR), GILL, JASWINDER5 (AUTHOR), ABADIA, ANTONIO ASSO6 (AUTHOR), KUEHL, MARTIN7 (AUTHOR), WOLPERT, CHRISTIAN8 (AUTHOR) |
| Source: |
Pacing & Clinical Electrophysiology. Jan2005 Supplement 1, Vol. 28, pS249-S254. 6p. 4 Charts, 2 Graphs. |
| Subject Terms: |
*IMPLANTABLE cardioverter-defibrillators, *IMPLANTED cardiovascular instruments, *DEFIBRILLATORS, *CARDIAC pacing, *TACHYARRHYTHMIAS |
| Abstract: |
STROHMER, B.,et al.: Impact of Dual Chamber Pacing on the Incidence of Atrial and Ventricular Tachyarrhythmias in Recipients of Implantable Cardioverter Defibrillators. 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 (P<0.05). 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 %VP>40% 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.(PACE 2005; 28:S249–S254) [ABSTRACT FROM AUTHOR] |
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