Implant and Long-Term Evaluation of Atrial Signal Amplification in a Single-Lead ICD.

Background: In patients without clinical indications for pacing the use of a single-lead implantable cardioverter defibrillator (ICD) implementing atrial sensing capability with proper signal amplification management may represent a useful therapeutic option, combining the positive features of both...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 35; no. 9; pp. 1119 - 1126
Autores principales: Stazi, Filippo, Mampieri, Massimo, Cardinale, Mario, Laudadio, M. Teresa, Gargaro, Alessio, Del Giudice, Giovanni Battista
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Sep2012
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Implant and Long-Term Evaluation of Atrial Signal Amplification in a Single-Lead ICD.
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        au:
          Stazi, Filippo
          Mampieri, Massimo
          Cardinale, Mario
          Laudadio, M. Teresa
          Gargaro, Alessio
          Del Giudice, Giovanni Battista
        affil: Department of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy; Centro per la Lotta contro l'Infarto (CLI) Foundation, Rome, Italy
      sug:
        subj:
          Atrial Fibrillation Prevention and Control
          Defibrillators, Implantable Equipment and Supplies
          Electrodes, Implanted Evaluation
          Tachycardia, Supraventricular Diagnosis
          Human
          Male
          Female
          Middle Age
          Descriptive Statistics
          Ventricular Ejection Fraction
          Data Analysis Software
          T-Tests
          Analysis of Variance
          Linear Regression
          Confidence Intervals
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background: In patients without clinical indications for pacing the use of a single-lead implantable cardioverter defibrillator (ICD) implementing atrial sensing capability with proper signal amplification management may represent a useful therapeutic option, combining the positive features of both single and dual-chamber devices. The aim of the study was to evaluate the atrial signal amplification and its long-term stability in a single-lead ICD system adding atrial sensing to a standard single-chamber ICD. Methods: P-wave amplitudes were collected and compared at implant both with a conventional external device ('unfiltered' P wave) and telemetrically with the implanted ICD ('filtered' P wave). Filtered/unfiltered P-wave ratio (amplification factor, AmF) was evaluated at implant and during follow-up. Results: In 43 enrolled patients (38 men, age 64 ± 16 years), the mean filtered P wave at implant was significantly higher than the unfiltered P wave (3.85 ± 0.81 mV vs 2.0 ± 1.49 mV; P < 10−11), with a mean AmF value of 2.77 ± 1.62. In seven patients with atrial fibrillation at implant, the AmF was higher (4.62 ± 1.94) than in patients in sinus rhythm (2.41 ± 1.30; P < 0.001). A significant linear correlation was found between the inverse of P wave and the AmF (R = 0.82, P < 0.00001). In 25 patients followed for 384 ± 244 days, atrial undersensing was never documented and AmF did not change from implant (3.19 ± 1.82; P = 0.24), also in different body position and breathing conditions. Conclusions: The single-lead ICD system evaluated reliably amplified P-wave amplitudes by a factor of about three, maintaining this performance during the observed follow-up. (PACE 2012; 35:1119-1125)
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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