Lower rate limit for pacing by cardiac resynchronization defibrillators: Should lower rate programming be reconsidered?
Background: No real-world large database associates lower rate limit (LRL) programming and survival of subjects with cardiac resynchronization therapy-defibrillators (CRT-Ds).Objective: The purpose of this study was to test the hypothesis that lower LRL programming is independently associated with s...
| Publicado en: | Heart Rhythm Vol. 18; no. 12; pp. 2087 - 2094 |
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| Autores principales: | , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Elsevier B.V.
Dec2021
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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=153495509&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 153495509 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15475271 EHI jtl: Heart Rhythm issn: 15475271 maglogo: N pubinfo: dt: Dec2021 vid: 18 iid: 12 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 153495509 153495509 NLM34371194 10.1016/j.hrthm.2021.07.068 NLM34371194 153495509 ppf: 2087 ppct: 7 formats: tig: atl: Lower rate limit for pacing by cardiac resynchronization defibrillators: Should lower rate programming be reconsidered? aug: au: Sharma, Arjun D. Wilkoff, Bruce L. Richards, Mark Wold, Nicholas Jones, Paul Perschbacher, David Olshansky, Brian affil: Unafiliated, Reno, Nevada sug: subj: Atrial Fibrillation Prevention and Control Heart Atrium Physiopathology Risk Assessment Methods Cardiac Resynchronization Therapy Methods Cardiac Resynchronization Therapy Adverse Effects Atrial Fibrillation Etiology Heart Rate Atrial Fibrillation Diagnosis Pacemaker, Artificial Standards Pacemaker, Artificial Statistics and Numerical Data Male Electrocardiography, Ambulatory Methods Defibrillators Standards Female Survival Analysis Treatment Outcomes Telemetry Aged Quality Improvement Risk Factors Aged: 65+ years Male Female ab: Background: No real-world large database associates lower rate limit (LRL) programming and survival of subjects with cardiac resynchronization therapy-defibrillators (CRT-Ds).Objective: The purpose of this study was to test the hypothesis that lower LRL programming is independently associated with survival, and that LRL and heart rate score (HrSc) are associated.Methods: All dual-chamber CRT-D devices in the Remote Patient Monitoring (RPM) ALTITUDE database (2006-2011) were queried. Baseline HrSc was defined as the percentage of all atrial sensed and paced beats in the tallest 10-beat histogram bin postimplant. LRL was assessed during repeated RPM uploads. Using a Cox model multivariable analysis, relationships between LRL, survival, HrSc, and other variables were evaluated. Survival was determined by query of death indices.Results: Data analyzed included 61,881 subjects (mean follow-up 2.9 years). LRL ranged from 40 to 85 bpm. Baseline lower LRL was associated with younger age, less atrial fibrillation, female sex, and lower HrSc (P <.001 for all covariates). Lower LRL was associated with improved survival, with LRL 40 associated with the largest survival benefit. This was significant for all 3 HrSc subgroups (P <.001). An interaction between HrSc and LRL was observed, with the largest survival difference between HrSc groups observed at LRL-40 (P <.001).Conclusion: LRL programming and HrSc were associated, and lower values of both were associated with improved survival in a large database of CRT-D subjects. Relationships between survival, LRL programming, and HrSc merit further study. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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