In:
Pacing and Clinical Electrophysiology, Wiley, Vol. 28, No. s1 ( 2005-01)
Abstract:
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.
Type of Medium:
Online Resource
ISSN:
0147-8389
,
1540-8159
DOI:
10.1111/pace.2005.28.issue-s1
DOI:
10.1111/j.1540-8159.2005.00002.x
Language:
English
Publisher:
Wiley
Publication Date:
2005
detail.hit.zdb_id:
2037547-5
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