Dual-chamber implantable cardioverter defibrillators reduce clinical adverse events related to atrial fibrillation when compared with single-chamber defibrillators: a subanalysis of the DATAS trial

Ricci, Renato Pietro; Quesada, Aurelio; Almendral, Jesús; Arribas, Fernando; Wolpert, Christian; Adragão, Pedro; Zoni-Berisso, Massimo; Navarro, Xavier; DeSanto, T.; Grammatico, Andrea; Santini, Massimo

doi:10.1093/europace/eup072

Cited by 21 publications

(14 citation statements)

References 33 publications

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“…This definition is reasonable and is in line with some previous findings in the field of AF and implantable devices. Many previous studies used a cut-off of 5 min in the Daily AF Burden (total time in AF during 1 day) to evaluate the presence or absence of clinically relevant AF [10,11,23,24]. This method allows the detection of any AF episode longer than 5 min and prevents the storage of artefacts, as artefacts mainly influence short episodes [13].…”

Section: Discussionmentioning

confidence: 99%

Ablation of paroxysmal atrial fibrillation during coronary artery bypass grafting: 12 months’ follow-up through implantable loop recorder

Pokushalov

Romanov

Cherniavsky

et al. 2011

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Ablation of paroxysmal atrial fibrillation during coronary artery bypass grafting: 12 months’ follow-up through implantable loop recorder

Pokushalov

Romanov

Cherniavsky

et al. 2011

European Journal of Cardio-Thoracic Surgery

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“…These parameters as well as all arrhythmic events were stored on floppy discs at each visit, 22 allowing subsequent analysis. Patients in whom ICD-EGs were not available for at least 3 months of follow-up were excluded.…”

Section: Methodsmentioning

confidence: 99%

Incidence, Determinants, and Prognostic Implications of True Pleomorphism of Ventricular Tachycardia in Patients With Implantable Cardioverter-Defribillators

Hadid

Almendral

Ortiz

et al. 2011

Circ: Arrhythmia and Electrophysiology

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Background-The occurrence of monomorphic ventricular tachycardia (M-VT) with Ͼ1 QRS morphology during the same episode (pleomorphism [PL]) or in different episodes (multiple morphologies [MM]) has been described through ECG. Implantable cardioverter-defribillator (ICD) electrograms (EGs) provide the opportunity to analyze virtually all spontaneous M-VT episodes. We sought to study the incidence, determinants, and prognostic significance of PL and MM as assessed by ICD-EG in a prospective series of patients with ICDs. Methods and Results-Spontaneous episodes of M-VT were analyzed before ICD intervention. PL was defined as Ͼ1 ICD-EG morphology, each having Ն6 consecutive identical beats during the same VT episode, and MM as Ͼ1 ICD-EG morphology in different M-VT episodes in the same patient. We analyzed 1881 M-VT episodes from 315 patients followed for 17 months. PL and MM occurred in 6% and 19%, respectively, of the total population (16% and 62% of patients with M-VT). Recurrent M-VT as diagnosis for ICD indication predicted PL and MM. Patients with PL more frequently developed MM (85% versus 15%; PϽ0.001) compared to patients without PL. Total mortality (5%) was significantly higher in patients with PL (20%), in patients with MM (11.5%), and in women (12%). In multivariate analysis, only PL (odds ratio, 5.33; Pϭ0.009) and female sex (odds ratio, 3.1; Pϭ0.038) predicted mortality. Conclusions-In a prospective series of patients with ICDs, mostly indicated for secondary prevention, both PL and MM of VT, as judged by ICD-EG, were not uncommon and were strongly associated. Female sex and the development of PL VT were the only independent predictors of mortality. (Circ Arrhythm Electrophysiol. 2011;4:33-42.)

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“…While several studies have compared outcomes between single-chamber and dual-chamber ICDs, these investigations had major limitations, yielded conflicting results, and predated the evidence on optimal programming of ICDs. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Today's health care providers and patients, therefore, often struggle in making the critical decision of what device type to choose, and professional societies and policymakers are incapable of developing evidence-based recommendations and coverage decisions. 8,33 These issues are further compounded by the advent of subcutaneous ICDs, whose outcomes, especially in the elderly, are uncertain.…”

Section: Professional Societies/ Researchersmentioning

confidence: 99%

Future Research Prioritization: Implantable Cardioverter-Defibrillator Therapy in Older Patients

et al. 2015

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BACKGROUND: Although the implantable cardioverterdefibrillator (ICD) is highly effective therapy for preventing sudden cardiac death, there is considerable uncertainty about its benefits and harms in older patients, especially in the presence of factors, other than old age, that increase the risk of death. OBJECTIVE: To develop a prioritized research agenda for the Patient-Centered Outcomes Research Institute as informed by a diverse group of stakeholders on the use and outcomes of the ICD in older patients. DESIGN: The existing literature was reviewed to identify evidence gaps, which were then refined by engaged stakeholders. Using a forced-ranking prioritization method, the stakeholders ranked evidence gaps by importance. For the highest-ranked evidence gaps, relevant recent studies were identified using PubMed, and relevant ongoing trials were identified using ClinicalTrials.gov. PARTICIPANTS: Eighteen stakeholders, including clinical experts and researchers in the prevention of sudden cardiac death and ICD therapy, representatives from federal and non-governmental funding agencies, representatives from relevant professional societies, health care decision-makers and policymakers, and representatives from related consumer and patient advocacy groups KEY RESULTS: The top 12 evidence gaps prioritized by stakeholders were related to the safety and effectiveness of ICDs in older patient subgroups not well represented in clinical trials, predictors of SCD, the impact of the ICD on quality of life, the use of shared decision-making, disparities in ICD use, risk stratification strategies, patient preferences, and distribution of modes of death in older patients. CONCLUSIONS: In this paper, we identify evidence gaps of high priority for current and future investigations of ICD therapy. Addressing these gaps will likely resolve many of the uncertainties surrounding the use and outcomes of the ICD in older patients seen in clinical practice.KEY WORDS: stakeholder engagement; cardiovascular disease; decision making.

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Dual-chamber implantable cardioverter defibrillators reduce clinical adverse events related to atrial fibrillation when compared with single-chamber defibrillators: a subanalysis of the DATAS trial

Abstract: Dual-chamber ICDs compared with single-chamber ICDs reduced the incidence of an endpoint composed by permanent AF, AF-related hospitalizations, and ICD shocks deemed inappropriate due to AF misclassification.

Cited by 21 publications

References 33 publications

Ablation of paroxysmal atrial fibrillation during coronary artery bypass grafting: 12 months’ follow-up through implantable loop recorder

Ablation of paroxysmal atrial fibrillation during coronary artery bypass grafting: 12 months’ follow-up through implantable loop recorder

Incidence, Determinants, and Prognostic Implications of True Pleomorphism of Ventricular Tachycardia in Patients With Implantable Cardioverter-Defribillators

Future Research Prioritization: Implantable Cardioverter-Defibrillator Therapy in Older Patients

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