Atrial tachyarrhythmia recurrence temporal patterns in bradycardia patients implanted with antitachycardia pacemakers.

INTRODUCTION: New-generation pacemakers allow continuous atrial tachyarrhythmia (AT) monitoring that provides accurate information about AT type, frequency, burden, and temporary evolution. METHODS AND RESULTS: We performed a prospective multicenter study to describe AT temporal patterns in patients...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 15; no. 1; pp. 44 - 52
Autores principales: Ricci R, Santini M, Padeletti L, Boriani G, Capucci A, Botto G, Gulizia M, Inama G, Galati A, Solimene F, Pepe M, Grammatico A
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jan2004
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2004
      vid: 15
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1046/j.1540-8167.2004.03317.x
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        atl: Atrial tachyarrhythmia recurrence temporal patterns in bradycardia patients implanted with antitachycardia pacemakers.
      aug:
        au:
          Ricci R
          Santini M
          Padeletti L
          Boriani G
          Capucci A
          Botto G
          Gulizia M
          Inama G
          Galati A
          Solimene F
          Pepe M
          Grammatico A
        affil: Institute of Cardiology, S. Filippo Neri Hospital, Rome, Italy; renatopietroricci@tin.it
      sug:
        subj:
          Bradycardia Therapy
          Pacemaker, Artificial
          Recurrence Epidemiology
          Tachycardia, Atrial Epidemiology
          Adult
          Aged
          Aged, 80 and Over
          Data Analysis, Statistical
          Female
          Male
          Prospective Studies
          Time Factors
          Human
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: INTRODUCTION: New-generation pacemakers allow continuous atrial tachyarrhythmia (AT) monitoring that provides accurate information about AT type, frequency, burden, and temporary evolution. METHODS AND RESULTS: We performed a prospective multicenter study to describe AT temporal patterns in patients with sinus bradycardia and AT. Two hundred forty patients (123 men; age 71 +/- 8 years) were implanted with a DDDRP pacemaker (model AT500, Medtronic Inc.). All patients were followed for 13 months. The first-month stabilization period of all patients was discarded from analysis. Seventy percent of patients had AT recurrences. Mean time to first AT recurrence (48.2 days, 95% confidence interval [CI] 37.0-59.5 days) was significantly longer than the time between first and second AT episode (10.3 days, 95% CI 6.7-13.9 days, P < 0.01). A minority of patients had a uniform time distribution of AT recurrences: <25% of patients had AT episodes in more than 6 of the 12 months considered in the study. The probability density function of consecutive sinus rhythm days between AT episodes was calculated for each of 40 patients who experienced >25 AT episodes and fitted by power law and exponential functions. The best fit was obtained by power law function in 60% of patients, by exponential function in 10%, and the two models gave comparable results in 30% of patients. CONCLUSION: In our population of patients with a history of sinus bradycardia and AT who were implanted with a new device equipped with atrial pacing therapies, 30% did not experience AT recurrences in the 12-month study period. Analysis of interevent time showed that in 60% of patients AT recurrences do not follow a uniform or random distribution. These findings bring into question the use of cross-over design and time to first AT recurrence as a clinical outcome in trials for AT therapy in this patient population.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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