Temporal patterns of atrial arrhythmia recurrences in patients with implantable defibrillators: implications for assessing antiarrhythmic therapies.

Introduction: The statistical measures commonly used to assess therapies for recurrent atrial arrhythmias (such as time to first recurrence) often assume a uniformly random pattern of arrhythmic events over time. However, the true temporal pattern of atrial arrhythmia recurrences is unknown. The aim...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 13; no. 4; pp. 303 - 310
Autores principales: Shehadeh LA, Liebovitch LS, Wood MA
Formato: research Journal Article
Publicado: Wiley-Blackwell Apr2002
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
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        atl: Temporal patterns of atrial arrhythmia recurrences in patients with implantable defibrillators: implications for assessing antiarrhythmic therapies.
      aug:
        au:
          Shehadeh LA
          Liebovitch LS
          Wood MA
      sug:
        subj:
          Atrial Fibrillation Epidemiology
          Atrial Fibrillation Therapy
          Defibrillators, Implantable Statistics and Numerical Data
          Heart Rate
          Adult
          Aged
          Aged, 80 and Over
          Antiarrhythmia Agents Therapeutic Use
          Atrial Fibrillation Diagnosis
          Female
          Male
          Middle Age
          Poisson Distribution
          Predictive Value of Tests
          Recurrence
          Regression
          Reproducibility of Results
          Resource Databases
          Retrospective Design
          Sensitivity and Specificity
          Tachycardia Classification
          Tachycardia Epidemiology
          Tachycardia Therapy
          Treatment Outcomes
          Human
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Introduction: The statistical measures commonly used to assess therapies for recurrent atrial arrhythmias (such as time to first recurrence) often assume a uniformly random pattern of arrhythmic events over time. However, the true temporal pattern of atrial arrhythmia recurrences is unknown. The aim of this study was to use linear and nonlinear analyses to characterize the temporal pattern of atrial arrhythmia recurrences in patients with implantable cardioverter defibrillators. Methods and Results: The time and date of atrial tachyarrhythmias recorded in 65 patients with combined atrial and ventricular defibrillators were used to construct a probability density function (PDF) and a model of a Poisson distribution of arrhythmic events for each patient. Average patient age was 66 ± 10 years and follow-up was 7.8 ± 4.8 months. A total of 10,759 episodes of atrial tachyarrhythmias were analyzed (range 43 to 618 episodes per patient). The PDF fit a power law distribution for all 65 patients, with an average r² = 0.89 ± 0.08. The PDF distribution differed significantly from the model Poisson distribution in 47 of 65 patients (P = 0.0002). Differences from the Poisson distribution were noted for patients both taking (30/43 patients; P <= 0.015) and not taking (17/22 patients; P <= 0.017) antiarrhythmic drugs. Median time between atrial arrhythmia detections for all 65 patients was 10.8 minutes. Conclusion: In implantable cardioverter defibrillator patients, the temporal pattern of frequent recurrences of atrial tachyarrhythmias usually is characterized by a power law distribution. The unique statistical properties of this type of distribution should be considered in designing outcome measures for treatment of atrial tachyarrhythmias.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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