scholarly journals Indications for dual-chamber cardioverter defibrillators at implant and at 1 year follow-up: a retrospective analysis in the single-chamber defibrillator era

EP Europace ◽  
2001 ◽  
Vol 3 (2) ◽  
pp. 132-135 ◽  
Author(s):  
A Proclemer
Keyword(s):  
Retrospective Analysis ◽  
Dual Chamber ◽  
Single Chamber ◽  
Cardioverter Defibrillators

P2878Higher all-cause mortality in patients with implanted dual-chamber cardioverter-defibrillators for secondary prevention: an analysis from the Polish ICD Registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
I Warchol ◽  
A Lubinski ◽  
M Sterlinski ◽  
O Kowalski ◽  
K Goscinska-Bis ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Implantable Cardioverter Defibrillators ◽  
Dual Chamber ◽  
Single Chamber ◽  
Kaplan Meier ◽  
Significant Difference ◽  
All Cause Mortality ◽  
National Cohort ◽  
Cardioverter Defibrillators

Abstract Background In the Polish ICD Registry population secondary prevention recipients account for over 27%. Despite the evolution of indications for secondary prevention implantable cardioverter defibrillators (ICDs), recommendations regarding the use of ICDs for secondary prevention of sudden cardiac death (SCD) rely on information from a small number of randomized controlled trials that were performed decades ago, with mixed results. Moreover, research on the outcomes after implantations for secondary prevention of ICDs is limited. While dual-chamber devices offer theoretical advantage over single-chamber devices, dual-chamber ICDs (DC-ICDs) were announced not superior to single-chamber (SC-ICDs) in some research. Purpose Therefore, the aim of the study was to evaluate the all-cause mortality among patients from the Polish ICD Registry receiving either a single- or a dual-chamber device for secondary prevention in contemporary clinical practice. Methods All patients enrolled in the Polish ICD Registry from 1995 to 2016 were identified. Patients were included in the study if they were designated as receiving an ICD for secondary prevention of SCD after documented tachycardic arrest, sustained ventricular tachycardia (VT), or syncope. Kaplan-Meier survival analysis was used to assess all-cause mortality. Results In the study population of 3596 ICD recipients (mean age 69±12 years, 81% male, SC-ICD 61%, DC-ICD 39%), during mean follow-up of 79±43 months all-cause mortality rate was higher in the dual-chamber group than in the single chamber group, with a significant difference between the two groups as depicted in Kaplan-Meier curve (p<0,05). The median survival time was 98 months versus 110 months for SC and DC-ICD, respectively. Conclusions This study is the first to describe the characteristics of a national cohort of patients receiving a secondary prevention ICD in such a long follow-up period in contemporary practice. Implantation of a dual-chamber ICD was associated with higher all-cause mortality compared with single chamber devices.

Long-Term Follow-Up of Patients Supplied with Single-Chamber or Dual-Chamber Cardioverter Defibrillators

2006 ◽  
Vol 29 (9) ◽  
pp. 946-952 ◽  
Author(s):  
CHRISTOF KOLB ◽  
ISABEL DEISENHOFER ◽  
SEBASTIAN SCHMIEDER ◽  
PETRA BARTHEL ◽  
BERNHARD ZRENNER ◽  
...  
Keyword(s):  
Dual Chamber ◽  
Single Chamber ◽  
Long Term Follow Up ◽  
Cardioverter Defibrillators

His-bundle pacing in CHF-patients with narrow QRS and chronic AF – an upgrade from single-chamber to dual-chamber ICD

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Ciesielski ◽  
A Slawuta ◽  
A Zabek ◽  
K Boczar ◽  
B Malecka ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Status ◽  
Chronic Atrial Fibrillation ◽  
Dual Chamber ◽  
Icd Implantation ◽  
Single Chamber ◽  
His Bundle ◽  
His Bundle Pacing ◽  
Short Period

Abstract   A single-chamber ICD is a standard method for primary SCD prophylaxis. In patients with chronic atrial fibrillation it does not contribute to the regularization of heart rate, which is crucial for proper treatment. Moreover, to avoid the deleterious effect of right ventricular pacing only minority of the patients with single chamber ICD get the appropriate, recommended dose of beta-blockers. The aim of our study was to assess the efficacy of direct His-bundle pacing in a population of patients with congestive heart failure and chronic atrial fibrillation using upgrade from single chamber to dual-chamber ICD and atrial channel to perform the His-bundle pacing Methods The study population included 39 patients (37 men, 2 women) aged 67.2±9.3 years, with CHF and chronic AF implanted primarily with single chamber ICD with established pharmacotherapy and stable clinical status. Results The echocardiography measurements at baseline and during follow-up were presented in the table: During short period (3–6 months) of follow-up the mean values of EF and LV dimensions significantly improved. This was also accompanied by functional status improvement. Conclusions His-bundle-based pacing in CHF-chronic AF patients contributes to significant echocardiographic and clinical improvement. Standard single-chamber ICD implantation in CHF-chronic AF patients yields only SCD prevention without influence on remodeling process. The physiological pacing contributes to better pharmacotherapy. Funding Acknowledgement Type of funding source: None

Inappropriate ICD shocks – a nightmare of the past or an ongoing problem?

2018 ◽  
Vol 1 (46) ◽  
pp. 49-50
Author(s):  
Paweł Syska
Keyword(s):  
Systematic Review ◽  
Ventricular Tachycardia ◽  
Meta Analysis ◽  
Regression Analyses ◽  
Single Chamber ◽  
Inappropriate Shocks ◽  
The Past ◽  
Meta Regression ◽  
Cardioverter Defibrillators

The discussed paper is a systematic review and meta-analysis of the studies concerning the inappropriate shocks (ISs) in single-chamber and subcutaneous cardioverter-defibrillators (S-ICDs). Based on the analysis of 16 selected articles, 6.4% of patients received an IS per year. Meta-regression analyses demonstrated that IS rates were lower in more recent studies and with longer follow-up. Use of S-ICDs and ventricular tachycardia zone programmed on did not significantly increase the risk of ISs. One of the studies showed markedly reduced annual ISs rate (1.9%).

2166A multicenter echocardiographic comparison on pacemaker-induced tricuspid valve regurgitation: leadless versus transvenous single-chamber and dual-chamber pacing therapy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N E G Beurskens ◽  
J Van Drooge ◽  
F Tjong ◽  
R Bon ◽  
K Dasselaar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Tricuspid Valve ◽  
Rank Test ◽  
Binary Logistic Regression Analysis ◽  
Heart Failure Hospitalization ◽  
Dual Chamber ◽  
Single Chamber ◽  
Total Cohort ◽  
The Impact

Abstract Background Pacemaker (PM) lead interference with tricuspid valve (TV) function is an important determinant of hemodynamic compromise and is associated with substantial morbidity and mortality. Lead-related TV regurgitation (TR) can potentially be mitigated by leadless pacemaker (LP) therapy by eliminating the presence of a transvalvular lead. Purpose This large multicenter study aimed to evaluate the impact of LP therapy on TV function in comparison with an age –, sex, and follow-up duration -matched cohort of transvenous single-chamber (VVI) and dual-chamber (DDD) PM recipients. Methods Leadless, and transvenous VVI and DDD-PM recipients who underwent an echocardiographic study prior to the procedure and 15±6 months thereafter between January 2013 and September 2018 at two tertiary centers in the Netherlands were included. We used the data of a prospectively acquired population that comprised consecutive patients who underwent LP implantation who were 1:1 matched to transvenous VVI-PM and DDD-PM patients. Results A total of 198 patients (129 males, age 79±8.2 years) were included, of whom 66 were implanted with a LP (two models: Nanostim, Micra LP), and 66 with a transvenous VVI and 66 with DDD-PM. In the total cohort, the Wilcoxon signed-rank test revealed that TR severity was graded more severe in 87 (44%), equally in 104 (53%), and less severe in 7 (4%) patients (p<0.001) compared with baseline echocardiographic findings. Worsening TR was observed in 28 (42%) of the LP (p<0.001) and 34 (52%) of transvenous VVI-PM (p<0.001), and 25 (38%) of the DDD-PM recipients (p<0.01). Binary logistic regression analysis showed that LP recipients were equally prone to increasing TV dysfunction compared with transvenous PMs (p=0.42). Septal position of the leadless intracardiac device (odds ratio 3.6, p=0.03) was associated with worsening TR. In the total cohort, 30 (15%) patients had heart failure hospitalization during the follow-up period. Conclusions TR is a malignant disease which can result in high rates of heart failure hospitalization. This study revealed an unexpected high proportion of patients with worsening TR following LP therapy, yet it was comparable to conventional PM systems. The mechanical impact of the LP near the TV apparatus is the most likely cause of this phenomenon since the septal positioning of the device was associated with increasing TV incompetence. The general consensus was that LP therapy mitigates the risk for TV dyfunction due to the circumvention of transvalvular leads. Therefore, the current results are highly clinically relevant as the contradict expected performance of the LP approach.

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