Temporal association between drops in thoracic impedance and malignant ventricular arrhythmia: A longitudinal analysis of remote monitoring trends.

Introduction: Thoracic impedance (TI) drops measured by implantable cardioverter‐defibrillators (ICDs) have been reported to correlate with ventricular tachycardia/fibrillation (VT/VF). The aim of our study was to assess the temporal association of decreasing TI trends with VT/VF episodes through a...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 34; no. 4; pp. 947 - 957
Autores principales: Rodio, Giovanna, Iacopino, Saverio, Pisanò, Ennio C., Calvi, Valeria, Rovaris, Giovanni, Marini, Massimiliano, Giammaria, Massimo, Caravati, Fabrizio, Maglia, Giampiero, Zanotto, Gabriele, Della Bella, Paolo, Biffi, Mauro, Curnis, Antonio, Maines, Massimiliano, Orsida, Daniela, Santamaria, Matteo, Bisignani, Giovanni, Baroni, Matteo, Lissoni, Fabio, Duca, Antonio
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Apr2023
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Temporal association between drops in thoracic impedance and malignant ventricular arrhythmia: A longitudinal analysis of remote monitoring trends.
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          Rodio, Giovanna
          Iacopino, Saverio
          Pisanò, Ennio C.
          Calvi, Valeria
          Rovaris, Giovanni
          Marini, Massimiliano
          Giammaria, Massimo
          Caravati, Fabrizio
          Maglia, Giampiero
          Zanotto, Gabriele
          Della Bella, Paolo
          Biffi, Mauro
          Curnis, Antonio
          Maines, Massimiliano
          Orsida, Daniela
          Santamaria, Matteo
          Bisignani, Giovanni
          Baroni, Matteo
          Lissoni, Fabio
          Duca, Antonio
        affil: Division of Cardiology, Ospedale Santissima Annunziata, Taranto, Italy
      sug:
        subj:
          Monitoring, Physiologic Methods
          Defibrillators, Implantable
          Ventricular Fibrillation
          Cardiac Resynchronization Therapy Methods
          Electric Impedance Methods
          Human
          Male
          Female
          Middle Age
          Aged
          Retrospective Design
          Record Review
          Confidence Intervals
          Prospective Studies
          Heart Failure
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Introduction: Thoracic impedance (TI) drops measured by implantable cardioverter‐defibrillators (ICDs) have been reported to correlate with ventricular tachycardia/fibrillation (VT/VF). The aim of our study was to assess the temporal association of decreasing TI trends with VT/VF episodes through a longitudinal analysis of daily remote monitoring data from ICDs and cardiac resynchronization therapy defibrillators (CRT‐Ds). Methods and Results: Retrospective data from 2384 patients were randomized 1:1 into a derivation or validation cohort. The TI decrease rate was defined as the percentage of rolling weeks with a continuously decreasing TI trend. The derivation cohort was used to determine a TI decrease rate threshold for a ≥99% specificity of arrhythmia prediction. The associated risk of VT/VF episodes was estimated in the validation cohort by dividing the available follow‐up into 60‐day assessment intervals. Analyses were performed separately for 1354 ICD and 1030 CRT‐D patients. During a median follow‐up of 2.0 years, 727 patients (30.4%) experienced 3298 confirmed VT/VF episodes. In the ICD group, a TI decrease rate of >60% was associated with a higher risk of VT/VF episode in a 60‐day assessment interval (stratified hazard ratio, 1.42; 95% confidence interval (CI), 1.05–1.92; p =.023). The TI decrease preceded (40.8%) or followed (59.2%) the VT/VF episodes. In the CRT‐D group, no association between TI decrease and VT/VF episodes was observed (p =.84). Conclusion: In our longitudinal analysis, TI decrease was associated with VT/VF episodes only in ICD patients. Preventive interventions may be difficult since episodes can occur before or after TI decrease.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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