Chronic experiences with a single lead dual chamber implantable cardioverter defibrillator system.
Monitoring of atrial rhythm in patients implanted with ICDs may improve accuracy in identifying supraventricular arrhythmias and, therefore, prevent inappropriate therapies. Since difficulties were found in dual chamber ICDs with separate leads, a new designed single lead dual chamber ICD system was...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 26; no. 10; pp. 1937 - 1944 |
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| Autores principales: | , , , , , , , |
| Formato: | diagnostic images pictorial research tables/charts tracings Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2003
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106749690&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106749690 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Oct2003 vid: 26 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106749690 106749690 2004100113 10.1046/j.1460-9592.2003.00299.x NLM14516332 106749690 ppf: 1937 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Chronic experiences with a single lead dual chamber implantable cardioverter defibrillator system. aug: au: Niehaus M De Sousa M Klein G Korte T Pfeiffer D Walles T Raymondos K Tebbenjohanns J affil: Dept of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; niehaus.michael@MH-Hannover.de sug: subj: Arrhythmia, Ventricular Therapy Defibrillators, Implantable Standards Electrodes, Implanted Standards Aged Atrial Fibrillation Diagnosis Atrial Flutter Diagnosis Descriptive Statistics Electrodes, Implanted Trends Female Fisher's Exact Test Male Tachycardia, Ventricular Diagnosis Tachycardia, Ventricular Therapy Unpaired T-Tests Ventricular Fibrillation Diagnosis Ventricular Fibrillation Therapy Funding Source Human Aged: 65+ years Female Male ab: Monitoring of atrial rhythm in patients implanted with ICDs may improve accuracy in identifying supraventricular arrhythmias and, therefore, prevent inappropriate therapies. Since difficulties were found in dual chamber ICDs with separate leads, a new designed single lead dual chamber ICD system was tested. Twenty-five patients implanted with a Deikos A+ (single coil defibrillation lead with two atrial sensing rings combined with a dual chamber ICD with a high amplifying atrial channel) were tested. Atrial and ventricular signals were analyzed during sinus rhythm (SR) and sinus tachycardias (STs), atrial flutter and AF, and VT or VF. Follow-ups were performed after 1, 3, 6, 9, and 12 months after implantation. Analysis of EGM amplitudes of stored episodes revealed that atrial signals during atrial flutter (2.1 +/- 0.51 mV) were comparable to those of ST (2.2 +/- 0.5 mV). Atrial amplitudes during AF were significantly lower (0.81 +/- 0.5 mV, P<0.01). During VF atrial 'sinus' signals (2 +/- 0.8 mV) were stable. Ventricular parameters did not differ from a standard ICD lead; defibrillation threshold was 11.4 +/- 4.5 J (16 patients). During intraoperative and prehospital discharge measurements, 97.1% of SR-P waves and 99.2% of atrial flutter waves were detected correctly. In AF 91.11% of atrial signals were detected. Analysis of 505 stored episodes showed that 96.8% of ST and 100% of atrial flutter and 100% of AF episodes have been classified correctly and no underdetection of VT/VF was found. The first experiences with the new VDD-ICD system show an increase of the specificity to detect ventricular tachycardias to a level comparable to dual chamber ICDs with two leads. The reliability of this system has to be proven in a prospective randomized study. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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