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Dominic A M J Theuns - One of the best experts on this subject based on the ideXlab platform.
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frequency of need for antitachycardia or Antibradycardia Pacing or cardiac resynchronization therapy in patients with a single chamber implantable cardioverter defibrillator
American Journal of Cardiology, 2018Co-Authors: Mireille C Melles, Singchien Yap, Rohit E Bhagwandien, Rafi Sakhi, Tamas Szilitorok, Dominic A M J TheunsAbstract:The subcutaneous implantable cardioverter-defibrillator (S-ICD) is unable to deliver antitachycardia Pacing (ATP), bradycardia Pacing, and cardiac resynchronization therapy (CRT). However, little is known about the proportion of patients that develop the need for 1 of these features. We evaluated the potential suitability for a S-ICD at the time of first replacement in a cohort of patients with a transvenous single-chamber device who did not need bradycardia Pacing at the time of implantation. The study cohort consisted of patients who received a transvenous single-chamber ICD between 1998 and September 2017. The primary end point was a combined end point of the need for atrial or ventricular Pacing, development of a CRT indication, or termination of ventricular arrhythmias by ATP delivery. During a mean follow-up of 5.6 ± 1.9 years, 78 of 254 patients (31%) reached the primary end point. The 7 years' cumulative S-ICD suitability rate was 65.6% (95% confidence interval [CI] 58.5% to 71.7%). Event rates were 9.5% (95% CI 6.5% to 13.9%) at 1-year follow-up, and 28.0% (95% CI 22.8% to 34.2%) at 5 years' follow-up. For individual end points, incidence rates were 1.8 (95% CI 1.2 to 2.6) per 100-patient-years for CRT, 0.3 (95% CI 0.1 to 0.8) per 100-patient-years for Pacing-dependency, and 4.9 (95% CI 3.8 to 6.3) per 100-patient-years for appropriate ATP therapy. No baseline variables for predicting S-ICD unsuitability were found. In conclusion, at the time of the first replacement, 69% of the patients with a single-chamber device would have been clinically eligible for the S-ICD. Incidence rates of developing a bradycardia Pacing and CRT indication are low.
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Longevity of the Subcutaneous Implantable Defibrillator: Long-Term Follow-Up of the European Regulatory Trial Cohort.
Circulation. Arrhythmia and electrophysiology, 2015Co-Authors: Dominic A M J Theuns, Ian Crozier, Craig S. Barr, Margaret Hood, Riccardo Cappato, Reinoud E. Knops, Alexander H. Maass, Lucas V.a. Boersma, Luc JordaensAbstract:Background— The recent advent of subcutaneous implantable cardioverter defibrillators (S-ICDs) has provided investigators with a safe and effective new therapy in patients at risk of sudden cardiac death. At present, no data are available with regard to the longevity of these new devices. This study evaluated the longevity of the S-ICD system. Methods and Results— All patients enrolled in the European Regulatory Trial were included in the analysis. During follow-up, time and causes of device replacement or explantation were assessed and categorized. Device longevity was estimated using Kaplan–Meier analysis. Fifty-five patients were followed for a median of 5.8 years. During follow-up, 26 (47%) patients underwent device replacement and 5 (9%) underwent device explantation. Median time to replacement was 5.0 years (Q1–Q3, 4.4–5.6 years). Replacement was caused by battery depletion in 25 patients (92%), of which 5 within 1.5 years because of premature battery depletion, and by infection in 1 patient (2%). Replacement for a transvenous ICD system was required in 4 patients (7%) because of ineffective defibrillation in 1 (0.003 per patient-year), need for resynchronization therapy in 2 (0.01 per patient-year), and for Antibradycardia Pacing in 1 (0.003 per patient-year). At 5 years follow-up, 71% of devices were still in service. Conclusions— This study provides the first estimate of S-ICD system longevity since its introduction in clinical practice. Median longevity of the first generation S-ICD system was 5.0 years. The majority of devices were replaced because of battery depletion. Clinical Trial Registration— URL: . Unique identifier: [NCT01117792][1]. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01117792&atom=%2Fcircae%2F8%2F5%2F1159.atom
M. Schlepper - One of the best experts on this subject based on the ideXlab platform.
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Neue Algorithmen zur Diskriminierung zwischen supraventrikulären und ventrikuären Tachyarrhythmien bei Patienten met implantierbarem Kardioverter-Defibrillator
Herzschrittmachertherapie und Elektrophysiologie, 1997Co-Authors: J. Neuzner, M. SchlepperAbstract:Die Spezifität der Detektion ventrikulärer Tachykardien ist in gegenwärtigen implantierbaren Kardioverter/Defibrillatoren (ICD) erheblich, eingeschränkt. Die technische Konzeption einer allein frequenzgebundenen Arrhythmiedetektion durch die einkanalige Analyse endokardialer elektrischer Signale erlaubt keine ausreichende Trennung zwischen supraventrikulären und ventrikulären Arrhythmien. Mindestens 25% aller dokumentierten elektrischen Therapien durch ICD-Systeme sind bedingt durch eine falsch positive Detektion supraventrikulärer Tachyarrhythmien. Der Einsatz alternativer Detektionsalgorithmen, die nicht auf der Analyse endokardialer, elektrischer Signale beruhen, ist durch Probleme der Langzeitstabilität und des Energiebedarfes eingeschränkt. Unter Beibehaltung des eingeführten technischen Konzeptes der Arrhythmiedetektion erlaubt die Analyse der zeitlichen Abfolge endokardialer Signale, wie die Beurteilung der Variabilität der Zykluslängen konsekutiver R-R Intervalle (“Rate-Stability”-Stabilitätskriterium) und die Beurteilung des plötzlichen Beginns einer Tachykardie (“Rate-Onset”) eine klinisch, signifikante Steigerung der Spezifität der Arrhythmiedetektion in ICD-Systemen. Detektionsalgorithmen, die auf der Morphologieanalyse endokardialer Signale beruhen, erlauben zwar eine deutliche Verbesserung der Differenzierung atrialer und ventrikulärer Rhythmen, wurden aber in der klinischen Therapie mit ICD-Systemen bis 1992 nur im beschränkten Umfang eingesetzt. Mit der Einführung des “width criterion”, das auf der vergleichenden Bestimmung der Breite endokardialer Signale beruht, wurde 1995 wieder erneut ein morphologisches Detektionskriterium in die klinische ICD-Therapie eingeführt. In den Jahren 1995 und 1996 erfolgten die Implantationen der ersten beiden Modellreihen eines Zweikammer-ICD-Systems mit der Option zu einer atrio-ventrikulären Arrhythmiedetektion und DDD-Antibradykardiestimulation. Von diesen DDD-ICD-Systemen ist der größte Beitrag zur Verbesserung der Spezifität der Detektion ventrikulärer Arrhythmien zu erwarten. Eine Reihe validierter Detektionsalgorithmen basieren auf der Erkennung atrialer und ventrikulärar Frequenzen deren Stabilität, Akzeleration und die Beurteilung der Assoziation zwischen atrialen und ventrikulären Signalen erlauben eine deutliche Steigerung der Genauigkeit in der Differenzierung supraventrikulärer und ventrikulärer Tachykardien. Von der zusätzlichen Implementierung morphologiegestützer Detektionsalgorithmen in DDD-ICD-Systems kann zukünftig eine Lösung des Problems der eingeschränkten Spezifität von ICD-Systemen in der Erkennung ventrikulärer Tachykardien erwartet werden. The current therapy with implantable cardioverter/defibrillators (ICD) is lacking specificity. The technical concept of arrhythmia detection, as a single channel ventricular rate threshold does not provide a clear differentiation between supraventricular and ventricular rhythms. Nearly 25% of all ICD-therapies are related to a false positive detection of supraventricular arrhythmias. The use of alternative, non rate based detection algorithms is limited due to the reduced long-term stability of the sensors and due to a high battery drain. Based on the current concept of arrhythmia detection, the use of additional timing algorithms as the variability of consecutive RR-cycle length (“Rate-Stability”) and the detection of a sudden acceleration in the ventricular rate (“Rate-Onset”) provide a clinical relevant increase in specificity in ICD-therapy. A further class of detection algorithms uses the morphologic assessment of intracardiac electrograms. Despite the fact that these morphology based algorithms have shown a high sensitivity and specificity in the discrimination between ventricular and non-ventricular rhythms, only one algorithm was implemented in ICD-generators and the clinical importance in ICD-therapy was very small. In 1995 a new morphology based detection algorithm was introduced in ICD-therapy. The “width criterion” is based on the measurment of the duration of the intracardiac signal. In 1995 and 1996 the first two series of a dual chamber ICD system were introduced in clinical ICD-therapy. These devices provide a two-channel atrio-ventricular arrhythmia detection in connection with a DDD Antibradycardia Pacing therapy. The use of DDD-ICD systems is expected to be a great step forward to enhance diagnostic specificty. A number of rate and timing detection algorithms and algorithms comparing the assoziation of atrial and ventricular signals may improve the discrimination between supraventricular and ventricular tachyarrhythmias. The future implementation of additional morphology based detection algorithms in DDD-ICD systems may solve the problem of the limited detection specificity in clinical ICD-therapy.
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Neue Algorithmen zur Diskriminierung zwischen supraventrikulären und ventrikuären Tachyarrhythmien bei Patienten met implantierbarem Kardioverter-Defibrillator
Herzschrittmachertherapie & Elektrophysiologie, 1997Co-Authors: J. Neuzner, M. SchlepperAbstract:The current therapy with implantable cardioverter/defibrillators (ICD) is lacking specificity. The technical concept of arrhythmia detection, as a single channel ventricular rate threshold does not provide a clear differentiation between supraventricular and ventricular rhythms. Nearly 25% of all ICD-therapies are related to a false positive detection of supraventricular arrhythmias.The use of alternative, non rate based detection algorithms is limited due to the reduced long-term stability of the sensors and due to a high battery drain. Based on the current concept of arrhythmia detection, the use of additional timing algorithms as the variability of consecutive RR-cycle length ("Rate-Stability") and the detection of a sudden acceleration in the ventricular rate ("Rate-Onset") provide a clinical relevant increase in specificity in ICD-therapy. A further class of detection algorithms uses the morphologic assessment of intracardiac electrograms. Despite the fact that these morphology based algorithms have shown a high sensitivity and specificity in the discrimination between ventricular and non-ventricular rhythms, only one algorithm was implemented in ICD-generators and the clinical importance in ICD-therapy was very small. In 1995 a new morphology based detection algorithm was introduced in ICD-therapy. The "width criterion" is based on the measurment of the duration of the intracardiac signal. In 1995 and 1996 the first two series of a dual chamber ICD system were introduced in clinical ICD-therapy. These devices provide a two-channel atrio-ventricular arrhythmia detection in connection with a DDD Antibradycardia Pacing therapy. The use of DDD-ICD systems is expected to be a great step forward to enhance diagnostic specificty. A number of rate and timing detection algorithms and algorithms comparing the assoziation of atrial and ventricular signals may improve the discrimination between supraventricular and ventricular tachyarrhythmias. The future implementation of additional morphology based detection algorithms in DDD-ICD systems may solve the problem of the limited detection specificity in clinical ICD-therapy.
J. Neuzner - One of the best experts on this subject based on the ideXlab platform.
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Zweikammer ICD zur Verhinderung von inadäquaten Therapieabgaben: Lohnt sich der Aufwand?
Herzschrittmachertherapie und Elektrophysiologie, 2000Co-Authors: J. Neuzner, J. Sperzel, J. Carlsson, B. SchulteAbstract:Eine falsch-positive Erkennung atrialer Tachyarrhythmien als ventrikuläre Rhythmusstörungen mit der Konsequenz elektrischer Therapien stellt auch heute noch ein bedeutsames klinisches Problem in der Therapie mit implantierbaren Kardiovertern/Defibrillatoren dar. Die methodischen Limitationen einer einkanaligen frequenzgebunden Arrhythmiedetektion wurden durch die Einführung ergänzender Arrhythmiedetektionskriterien zu überwinden versucht. Neben den seit Jahren eingeführten, ergänzenden Detektionskriterien wie “Arrhythmiestabilität” und “Arrhythmieonset” wurden zusätzlich Detektionskriterien basierend auf der Morphologieanalyse der endokardialen Elektrogramme in die klinische Therapie mit implantierbaren Defibrillatoren eingeführt. Die Einführung von Zweikammer-Defibrillator-Systemen brachte neben der wichtigen Therapieoption einer physiologischen antibradykarden Stimulation die methodischen Voraussetzungen einer verbesserten Arrhythmiedetektion durch eine simultane Zwei-Kanal-Analyse atrialer und ventrikulärer Signale. In der vorliegenden Übersicht sollen die unterschiedlichen technischen Bedingungen der Arrhythmiedetektion in Einkammer- und Zweikammer-Defibrillatoren unter Einbeziehung der Mehrzahl der klinisch eingeführten ergänzenden Detektionskriterien und Algorithmen kurz zusammenfassend beschrieben werden. Weiter wird versucht eine Übersicht über publizierte Studien und Behandlungsergebnisse zur Sensitivität und Spezifität der Arrhythmiedetektion durch Einkammer und Zweikammer Defibrillatoren darzustellen. False-positive detection of atrial tachyarrhythmias as ventricular arrhythmias, resulting in electrical therapy, is still a major clinical problem in implantable defibrillator therapy. The introduction of enhanced arrhythmia detection parameters tried to overcome the methodical limitations of a single-channel arrhythmia classification. In addition to the enhanced detection parameters, such as “arrhythmia-stability” and “arrhythmia-onset”, introduced several years ago, new additional detection parameters, based on the analysis of intracardiac electrogram morphology, were recently introduced in clinical defibrillator therapy. The introduction of dual-chamber defibrillators provide the important option of physiological Antibradycardia Pacing and the technical preconditions for an improved arrhythmia classification, based on the simultaneous dual-channel analysis of atrial and ventricular signals. This manuscript will give and an overview of the technical conditions of arrhythmia detection in single and dual-chamber implantable defibrillators with respect to the majority of the clinically used enhanced arrhythmia detection parameters and detection algorithms. Additionally a summary of published studies and clinical results regarding the sensitivity and specificity of arrhythmia detection in single and dual-chamber implantable defibrillator therapy is presented.
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Neue Algorithmen zur Diskriminierung zwischen supraventrikulären und ventrikuären Tachyarrhythmien bei Patienten met implantierbarem Kardioverter-Defibrillator
Herzschrittmachertherapie und Elektrophysiologie, 1997Co-Authors: J. Neuzner, M. SchlepperAbstract:Die Spezifität der Detektion ventrikulärer Tachykardien ist in gegenwärtigen implantierbaren Kardioverter/Defibrillatoren (ICD) erheblich, eingeschränkt. Die technische Konzeption einer allein frequenzgebundenen Arrhythmiedetektion durch die einkanalige Analyse endokardialer elektrischer Signale erlaubt keine ausreichende Trennung zwischen supraventrikulären und ventrikulären Arrhythmien. Mindestens 25% aller dokumentierten elektrischen Therapien durch ICD-Systeme sind bedingt durch eine falsch positive Detektion supraventrikulärer Tachyarrhythmien. Der Einsatz alternativer Detektionsalgorithmen, die nicht auf der Analyse endokardialer, elektrischer Signale beruhen, ist durch Probleme der Langzeitstabilität und des Energiebedarfes eingeschränkt. Unter Beibehaltung des eingeführten technischen Konzeptes der Arrhythmiedetektion erlaubt die Analyse der zeitlichen Abfolge endokardialer Signale, wie die Beurteilung der Variabilität der Zykluslängen konsekutiver R-R Intervalle (“Rate-Stability”-Stabilitätskriterium) und die Beurteilung des plötzlichen Beginns einer Tachykardie (“Rate-Onset”) eine klinisch, signifikante Steigerung der Spezifität der Arrhythmiedetektion in ICD-Systemen. Detektionsalgorithmen, die auf der Morphologieanalyse endokardialer Signale beruhen, erlauben zwar eine deutliche Verbesserung der Differenzierung atrialer und ventrikulärer Rhythmen, wurden aber in der klinischen Therapie mit ICD-Systemen bis 1992 nur im beschränkten Umfang eingesetzt. Mit der Einführung des “width criterion”, das auf der vergleichenden Bestimmung der Breite endokardialer Signale beruht, wurde 1995 wieder erneut ein morphologisches Detektionskriterium in die klinische ICD-Therapie eingeführt. In den Jahren 1995 und 1996 erfolgten die Implantationen der ersten beiden Modellreihen eines Zweikammer-ICD-Systems mit der Option zu einer atrio-ventrikulären Arrhythmiedetektion und DDD-Antibradykardiestimulation. Von diesen DDD-ICD-Systemen ist der größte Beitrag zur Verbesserung der Spezifität der Detektion ventrikulärer Arrhythmien zu erwarten. Eine Reihe validierter Detektionsalgorithmen basieren auf der Erkennung atrialer und ventrikulärar Frequenzen deren Stabilität, Akzeleration und die Beurteilung der Assoziation zwischen atrialen und ventrikulären Signalen erlauben eine deutliche Steigerung der Genauigkeit in der Differenzierung supraventrikulärer und ventrikulärer Tachykardien. Von der zusätzlichen Implementierung morphologiegestützer Detektionsalgorithmen in DDD-ICD-Systems kann zukünftig eine Lösung des Problems der eingeschränkten Spezifität von ICD-Systemen in der Erkennung ventrikulärer Tachykardien erwartet werden. The current therapy with implantable cardioverter/defibrillators (ICD) is lacking specificity. The technical concept of arrhythmia detection, as a single channel ventricular rate threshold does not provide a clear differentiation between supraventricular and ventricular rhythms. Nearly 25% of all ICD-therapies are related to a false positive detection of supraventricular arrhythmias. The use of alternative, non rate based detection algorithms is limited due to the reduced long-term stability of the sensors and due to a high battery drain. Based on the current concept of arrhythmia detection, the use of additional timing algorithms as the variability of consecutive RR-cycle length (“Rate-Stability”) and the detection of a sudden acceleration in the ventricular rate (“Rate-Onset”) provide a clinical relevant increase in specificity in ICD-therapy. A further class of detection algorithms uses the morphologic assessment of intracardiac electrograms. Despite the fact that these morphology based algorithms have shown a high sensitivity and specificity in the discrimination between ventricular and non-ventricular rhythms, only one algorithm was implemented in ICD-generators and the clinical importance in ICD-therapy was very small. In 1995 a new morphology based detection algorithm was introduced in ICD-therapy. The “width criterion” is based on the measurment of the duration of the intracardiac signal. In 1995 and 1996 the first two series of a dual chamber ICD system were introduced in clinical ICD-therapy. These devices provide a two-channel atrio-ventricular arrhythmia detection in connection with a DDD Antibradycardia Pacing therapy. The use of DDD-ICD systems is expected to be a great step forward to enhance diagnostic specificty. A number of rate and timing detection algorithms and algorithms comparing the assoziation of atrial and ventricular signals may improve the discrimination between supraventricular and ventricular tachyarrhythmias. The future implementation of additional morphology based detection algorithms in DDD-ICD systems may solve the problem of the limited detection specificity in clinical ICD-therapy.
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Neue Algorithmen zur Diskriminierung zwischen supraventrikulären und ventrikuären Tachyarrhythmien bei Patienten met implantierbarem Kardioverter-Defibrillator
Herzschrittmachertherapie & Elektrophysiologie, 1997Co-Authors: J. Neuzner, M. SchlepperAbstract:The current therapy with implantable cardioverter/defibrillators (ICD) is lacking specificity. The technical concept of arrhythmia detection, as a single channel ventricular rate threshold does not provide a clear differentiation between supraventricular and ventricular rhythms. Nearly 25% of all ICD-therapies are related to a false positive detection of supraventricular arrhythmias.The use of alternative, non rate based detection algorithms is limited due to the reduced long-term stability of the sensors and due to a high battery drain. Based on the current concept of arrhythmia detection, the use of additional timing algorithms as the variability of consecutive RR-cycle length ("Rate-Stability") and the detection of a sudden acceleration in the ventricular rate ("Rate-Onset") provide a clinical relevant increase in specificity in ICD-therapy. A further class of detection algorithms uses the morphologic assessment of intracardiac electrograms. Despite the fact that these morphology based algorithms have shown a high sensitivity and specificity in the discrimination between ventricular and non-ventricular rhythms, only one algorithm was implemented in ICD-generators and the clinical importance in ICD-therapy was very small. In 1995 a new morphology based detection algorithm was introduced in ICD-therapy. The "width criterion" is based on the measurment of the duration of the intracardiac signal. In 1995 and 1996 the first two series of a dual chamber ICD system were introduced in clinical ICD-therapy. These devices provide a two-channel atrio-ventricular arrhythmia detection in connection with a DDD Antibradycardia Pacing therapy. The use of DDD-ICD systems is expected to be a great step forward to enhance diagnostic specificty. A number of rate and timing detection algorithms and algorithms comparing the assoziation of atrial and ventricular signals may improve the discrimination between supraventricular and ventricular tachyarrhythmias. The future implementation of additional morphology based detection algorithms in DDD-ICD systems may solve the problem of the limited detection specificity in clinical ICD-therapy.
Gerd Fröhlig - One of the best experts on this subject based on the ideXlab platform.
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biventricular versus conventional right ventricular stimulation for patients with standard Pacing indication and left ventricular dysfunction the homburg biventricular Pacing evaluation hobipace
Journal of the American College of Cardiology, 2006Co-Authors: Michael Kindermann, Benno Hennen, Jens Jung, Jurgen Geisel, Michael Bohm, Gerd FröhligAbstract:Objectives The Homburg Biventricular Pacing Evaluation (HOBIPACE) is the first randomized controlled study that compares the biventricular (BV) Pacing approach with conventional right ventricular (RV) Pacing in patients with left ventricular (LV) dysfunction and a standard indication for Antibradycardia Pacing in the ventricle. Background In patients with LV dysfunction and atrioventricular block, conventional RV Pacing may yield a detrimental effect on LV function. Methods Thirty patients with standard indication for permanent ventricular Pacing and LV dysfunction defined by an LV end-diastolic diameter ≥60 mm and an ejection fraction ≤40% were included. Using a prospective, randomized crossover design, three months of RV Pacing were compared with three months of BV Pacing with regard to LV function, N-terminal pro-B-type natriuretic peptide (NT-proBNP) serum concentration, exercise capacity, and quality of life. Results When compared with RV Pacing, BV stimulation reduced LV end-diastolic (−9.0%, p = 0.022) and end-systolic volumes (−16.9%, p Conclusions In patients with LV dysfunction who need permanent ventricular Pacing support, BV stimulation is superior to conventional RV Pacing with regard to LV function, quality of life, and maximal as well as submaximal exercise capacity.
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Selective site Pacing: the right ventricular approach.
Pacing and Clinical Electrophysiology, 2004Co-Authors: Gerd Fröhlig, Bernhard Schwaab, Michael KindermannAbstract:Animal data and recent findings in humans have questioned the appropriateness of Pacing the heart from the right ventricular apex. Numerous, mostly small sized, studies have evaluated alternative sites within the right ventricle. There is now sufficient evidence that right ventricular apical Pacing in patients with left ventricular dysfunction with or without heart failure is detrimental. Pacing from the right side of the heart as an attempt at nonpharmacological therapy for heart failure, turns out to be obsolete. In Antibradycardia Pacing with the need for continuous ventricular support, the interest in preserving left ventricular function drives the ongoing search for the most favorable Pacing site within the right ventricle. Results, so far, are conflicting which may be attributed to the inhomogeneity of patient groups, the small cohorts studied, the differing protocols used, and the lack of accepted definitions of right ventricular lead positions. Larger studies are needed to evaluate intraoperative criteria for optimal lead placement and the potential benefit of nonapical right ventricular Pacing.
Martin Cohen - One of the best experts on this subject based on the ideXlab platform.
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Patients, Mean Age 70 Years, With Automatic Implantable Cardioverter-Defibrillators Treated With Dual-Chamber Rate Responsive Pacing (DDDR-70) Have a Higher Mortality Than Patients With Backup Ventricular Pacing
2015Co-Authors: Rishi Sukhija, Wilbert S. Aronow, Carmine Sorbera, Kiran Yalamanchili, Martin CohenAbstract:Background. One study showed in 506 patients with automatic implantable cardioverter-defibrillators (AICDs) that the mortality at 1-year follow-up was 6.5 % with ventricular backup Pacing at 40/minute (VVI-40) versus 10.1 % in patients with dual-chamber rate responsive Pacing at 70/minute (DDDR-70). Methods. We performed a retrospective study to determine all-cause mortality in all patients at a university hospital who had AICDs without indications for Antibradycardia Pacing. Of 535 patients, mean age 70 6 12 years, 271 pa-tients had backup ventricular Pacing with a VVI-40, and 264 patients had dual-chamber rate responsive Pacing with a DDDR-70. Results. At 3.7-year mean follow-up, all-cause mortality was 19 % (50 of 264 patients) in patients with DDDR-70 Pacing versus 11 % (29 of 271 patients) with VVI-40 Pacing ( p,.01). Conclusion. Because of the increased mortality, increased cost, and complexity for dual-chamber rate responsive Pacing in patients with AICDs, concomitant DDDR Pacing at a rate of 70/minute in patients without an indication for Antibradycardia Pacing is not warranted. AUTOMATIC implantable cardioverter-defibrillators(AICDs) have been demonstrated to reduce all-cause mortality in patients at high risk for mortality because of life-threatening ventricular arrhythmias (1–6). The Ameri
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Left ventricular ejection fraction and prevalence of new left ventricular wall motion abnormality at long-term follow-up in patients with automatic implantable cardioverter-defibrillators treated with dual-chamber rate-responsive Pacing at a rate of
The American journal of cardiology, 2005Co-Authors: Rishi Sukhija, Wilbert S. Aronow, Carmine Sorbera, Priyanka Kakar, Stephen J. Peterson, William H. Frishman, Martin CohenAbstract:Baseline and long-term follow-up 2-dimensional echocardiograms were obtained in 160 patients with automatic implantable cardioverter-defibrillators without indications for Antibradycardia Pacing, who had backup ventricular Pacing at a rate of 40/minute (VVI-40) or dual-chamber rate-responsive Pacing at a rate of 70/minute (DDDR-70). At 37 months of follow-up for 80 patients treated with VVI-40 and 23 months of follow-up for 80 patients treated with DDDR-70, the mean left ventricular ejection fraction was 36 ± 8% at baseline and 36 ± 8% at follow-up and 36 ± 7% at baseline and 30 ± 7% at follow-up (p 7% in 25 of 80 patients (31%)treated with DDDR-70 and in 9 of 80 patients (11%) treated with VVI-40 (p
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Patients, Mean Age 70 Years, With Automatic Implantable Cardioverter-Defibrillators Treated With Dual-Chamber Rate Responsive Pacing (DDDR-70) Have a Higher Mortality Than Patients With Backup Ventricular Pacing (VVI-40) at 3.7-Year Follow-Up
The journals of gerontology. Series A Biological sciences and medical sciences, 2005Co-Authors: Rishi Sukhija, Wilbert S. Aronow, Carmine Sorbera, Kiran Yalamanchili, Martin CohenAbstract:Background. One study showed in 506 patients with automatic implantable cardioverter-defibrillators (AICDs) that the mortality at 1-year follow-up was 6.5% with ventricular backup Pacing at 40/minute (VVI-40) versus 10.1% in patients with dual-chamber rate responsive Pacing at 70/minute (DDDR-70). Methods. We performed a retrospective study to determine all-cause mortality in all patients at a university hospital who had AICDs without indications for Antibradycardia Pacing. Of 535 patients, mean age 70 6 12 years, 271 patients had backup ventricular Pacing with a VVI-40, and 264 patients had dual-chamber rate responsive Pacing with a DDDR-70. Results. At 3.7-year mean follow-up, all-cause mortality was 19% (50 of 264 patients) in patients with DDDR-70 Pacing versus 11% (29 of 271 patients) with VVI-40 Pacing (p , .01). Conclusion. Because of the increased mortality, increased cost, and complexity for dual-chamber rate responsive Pacing in patients with AICDs, concomitant DDDR Pacing at a rate of 70/minute in patients without an indication for Antibradycardia Pacing is not warranted.