Clinical and Quality of Life Comparison of Accelerometer, Piezoelectric Crystal, and Blended Sensors in DDDR-Paced Patients with Sinus Node Dysfunction in the Mode Selection Trial (MOST)

2005 ◽  
Vol 28 (8) ◽  
pp. 762-770 ◽  
Author(s):  
HIMANSHU H. SHUKLA ◽  
GREG C. FLAKER ◽  
ANNE S. HELLKAMP ◽  
ERSKINE A. JAMES ◽  
KERRY L. LEE ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sinus Node ◽  
Mode Selection ◽  
Sinus Node Dysfunction ◽  
Piezoelectric Crystal

Abstract 15680: Sinus Node Dysfunction in Associated With Higher Symptom Burden and Increased Risk of Progression to Permanent Atrial Fibrillation: Results From ORBIT-AF Registry

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Larry R Jackson ◽  
Sung Hee Kim ◽  
Jonathan P Piccini ◽  
Bernard J Gersh ◽  
Gerald V Naccarelli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Sinus Bradycardia ◽  
Sinus Node ◽  
Sinus Node Dysfunction ◽  
Left Ventricular Ejection ◽  
Increased Risk ◽  
Risk Of Progression

Background: Patients with sinus node dysfunction (SND) are at increased risk of atrial tachyarrhythmias, including atrial fibrillation (AF). Whether the presence of SND is also associated with worse outcomes among those with AF has not been well described. Methods: The ORBIT-AF registry enrolled patients with AF from a range of clinical practices across the US. SND was defined clinically, based on the presence of sinus bradycardia, severe sinus bradycardia, sinus arrest, sinoatrial exit block, or features of tachycardia-bradycardia syndrome. Descriptive statistics and multivariable logistic regression analysis were used to describe treatment patterns and outcomes for patients with and without SND and AF. Results: Overall, 1,710 (17.7%) patients had SND at enrollment. Patients with SND had lower left-ventricular ejection fractions, higher CHA 2 DS 2 -VASc risk scores, and more prior cerebrovascular events. Patients with SND had more severe symptoms (EHRA class IV: 17.5% vs. 13.9%; p=0.007) and poorer quality of life (median AFEQT 77.5 vs. 81.1; p=0.008) as compared to those without. SND patients were more frequently treated with oral anticoagulants (79.2% vs. 75.9%, p=0.004) and had more often received interventional therapy for AF (16.1% vs. 10.5%, p<0.0001). There were no differences in the current AF management strategy between patients with SND and those without [rate control (69.7% vs. 67.7%), rhythm control (30.0% vs. 32.0%); P=0.11]. After adjustment, significantly more patients with SND had progressed from paroxysmal AF at baseline to persistent or permanent AF at any follow-up or persistent AF at baseline to permanent AF at any follow-up than those without (OR 1.23, 95% CI 1.01-1.49, p=0.035). Conclusion: Sinus node dysfunction is associated worse symptoms, lower quality of life, and higher risk of progression to permanent AF. However, SND is not associated with increased risk of all-cause hospitalization, incident stroke, or all-cause death.

Recurrence or neurological loss? Resection mode selection for patients with large sacral chordoma: an analysis of prognostic factors and quality of life

2019 ◽  
Vol 161 (12) ◽  
pp. 2433-2441
Author(s):  
Xin Gao ◽  
Qi Jia ◽  
Xiaopan Cai ◽  
Chenglong Zhao ◽  
Jiaxiang Yang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prognostic Factors ◽  
Mode Selection ◽  
Sacral Chordoma ◽  
Selection For

Inadekvát, aránytalan sinuscsomó-tachycardia: egy régi szívritmuszavar új megvilágításban (II.)

2020 ◽  
Vol 161 (46) ◽  
pp. 1953-1958
Author(s):  
József Borbola ◽  
Csaba Földesi ◽  
Attila Kardos ◽  
Zoltán Som
Keyword(s):  
Quality Of Life ◽  
Heart Rate ◽  
Drug Therapy ◽  
Sinus Node ◽  
Heart Rhythm ◽  
Pharmacological Therapy ◽  
Dynamic Exercise ◽  
Exercise Tests ◽  
Sinus Rate

Összefoglaló. Bevezetés: Az inadekvát, aránytalan sinuscsomó-tachycardia a szív nomotop ingerképzési zavarával járó, nem ritka klinikai szindróma. A szívritmuszavar-entitást a nem paroxysmalis, magas nyugalmi sinusfrekvencia, a fizikai/pszichés stresszre adott aránytalan sinustachycardia, valamint főként palpitációs panaszok jellemzik. Célkitűzés: Az aránytalan sinuscsomó-tachycardiás betegeink gyógyszeres kezelésével szerzett tapasztalataink ismertetése. Módszerek: 2008 és 2018 között 104 beteget (92 nő, 12 férfi; átlagéletkor 31 ± 10 év) kezeltünk ezzel a szívritmuszavarral. A betegek kivizsgálásuk után 12 elvezetéses EKG-, terheléses EKG-, valamint 24 órás Holter-monitoros EKG-megfigyeléseken vettek részt a gyógyszeres kezelés előtt és után (bizoprolol: 2 × 5 mg/nap; ivabradin: 2 × 5 mg/nap). Az életminőség változását a European Heart Rhythm Association (EHRA) tüneti skálája szerint állapítottuk meg. Eredmények: Mindkét gyógyszer jelentősen csökkentette a nyugalmi sinusfrekvenciát (kontroll: 102 ± 10/min; bizoprolol: 78 ± 6/min; ivabradin: 74 ± 8/min, mindkettő: p<0,0001). A gyógyszeres kezelés nélküli, 24 órás Holter-monitoros EKG-felvételek során mért szívfrekvenciák (minimum–maximum [átlag] sinusfrekvencia/min) a kontrollértékekről (58 ± 8–159 ± 14 [94 ± 6]/min) mindkét gyógyszerre egyaránt szignifikánsan csökkentek (bizoprolol: 53 ± 7–132 ± 13 [77 ± 9]/min [mindhárom: p<0,0001]; ivabradin 51 ± 6–134 ± 18 [77 ± 8]/min [mindhárom: p<0,0001]). A terheléses EKG-vizsgálatok előtt (kontroll: 99 ± 13/min; bizoprolol 81 ± 11/min [p<0,0001]; ivabradin: 84 ± 10/min [p<0,0001]) és a terhelés csúcspontján mért sinusfrekvenciák (kontroll: 164 ± 15/min; bizoprolol: 140 ± 16/min [p<0,0001]; ivabradin: 142 ± 14/min [p<0,0001]) is jelentősen mérséklődtek. Az azonos dózisban adott két gyógyszer szívfrekvencia-csökkentő hatásai között számottevő különbséget nem tapasztaltunk. Az életminőséget tükröző EHRA tüneti skálán (kontroll: 2,3 ± 0,7) mind a bizoprolol (1,4 ± 1,4; p<0,0001), mind az ivabradin (1,1 ± 0,2; p<0,0001) egyformán csökkentette a betegek tüneteit, panaszait. Számottevő cardiovascularis mellékhatás egyik betegcsoportban sem jelentkezett. Következtetések: Vizsgálati eredményeink alapján megállapítható, hogy az aránytalan sinuscsomó-tachycardiás betegek gyógyszeres kezelésére: (1) a kardiospecifikus adrenerg béta-blokkoló bizoprolol és az If-csatorna-gátló ivabradin egyaránt hatékonynak és biztonságosnak bizonyult; (2) az azonos adagban adott két gyógyszer hatékonysága között számottevő különbség nem volt; (3) a gyógyszeres kezelés nemcsak a sinusfrekvenciát csökkentette, hanem a betegek panaszait, tüneteit is mérsékelte. Orv Hetil. 2020; 161(46): 1953–1958. Summary. Introduction: The inadequate, inappropriate sinus-node tachycardia is not a rare clinical syndrome, defined as a disturbance of the nomotopic impulse formation of the heart. This cardiac arrhythmic entity is characterized by a non-paroxismal, increased sinus rate at rest, and/or inadequate response to physical and/or emotional stress and palpitations. Objective: The aim of this study was to describe our experiences with pharmacological therapy of patients with inappropriate sinus tachycardia syndrome. Methods: Between 2008 and 2018, 104 patients (92 women, 12 men, mean age: 31 ± 10 years) were treated with this cardiac arrhythmia entity. All patients underwent 12-lead ECG, 24-hour Holter-ECG monitoring and standard bicycle dynamic exercise tests before and after drug treatment (bisoprolol: 5 mg bid; ivabradine: 5 mg bid). Changes in the quality of life were estimated by using the European Heart Rhythm Association (EHRA) score. Results: Both drugs decreased significantly the resting heart rate (control: 102 ± 10/min; bisoprolol 78 ± 6/min (p<0.0001), ivabradine: 74 ± 8/min (p<0.0001). The results of the parameters of the 24-hour Holter ECG recordings (expressed as minimal–maximal [average] heart rate/min) with drug therapy showed a significant decrease from control values in all three parameters: control 58 ± 8–159 ± 14 (94 ± 6)/min; bisoprolol 53 ± 7–132 ±13 (77 ± 9)/min (all three: p<0.0001); ivabradine: 51 ± 6–134 ± 18 (77 ± 8)/min (all three: p<0.0001). The sinus rate reduced significantly both before the bicycle dynamic exercise tests (control: 99 ± 13/min; bisoprolol: 81 ± 11/min [p<0.0001]; ivabradine: 84 ± 10/min [p<0.0001]) and at the peaks of the exercise test (control: 164 ± 15/min; bisoprolol: 140 ± 16/min [p<0.0001]; ivabradine 142 ± 14/min [p<0.0001]). The heart rate reducing effects of the two drugs did not differ significantly. The EHRA quality of life score was equally improved by the two drugs (control: 2.3 ± 0.7; bisoprolol: 1.4 ± 1.4 [p<0.0001]; ivabradine: 1.1 ± 0.2 [p<0.0001]). No cardiovascular side effects were observed while taking bisoprolol or ivabradine. Conclusions: Based on our clinical results, it can be pointed out that in the drug therapy of patients with inappropriate sinus node tachycardia: (1) bisoprolol (5 mg bid) and ivabradine (5 mg bid) proved to be equally effective and safe; (2) the heart rate reducing effect of the two drugs – given in the same dosage – did not differ considerably; (3) the pharmacological therapy significantly decreased not only the sinus frequency, but also reduced the symptoms of the patients. Orv Hetil. 2020; 161(46): 1953–1958.

Adverse Effects of First-Degree AV-Block in Patients with Sinus Node Dysfunction: Data from the Mode Selection Trial

2014 ◽  
Vol 37 (9) ◽  
pp. 1111-1119 ◽  
Author(s):  
FREDRIK HOLMQVIST ◽  
ANNE S. HELLKAMP ◽  
KERRY L. LEE ◽  
GERVASIO A. LAMAS ◽  
JAMES P. DAUBERT
Keyword(s):  
Adverse Effects ◽  
Sinus Node ◽  
Mode Selection ◽  
Sinus Node Dysfunction ◽  
Av Block

scholarly journals Atrial fibrillation and quality of life after pacemaker implantation for sick sinus syndrome: Data from the Mode Selection Trial (MOST)

2009 ◽  
Vol 158 (1) ◽  
pp. 78-83.e2 ◽  
Author(s):  
Kirsten E. Fleischmann ◽  
E. John Orav ◽  
Gervasio A. Lamas ◽  
Carol M. Mangione ◽  
Eleanor B. Schron ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Sick Sinus Syndrome ◽  
Mode Selection ◽  
Pacemaker Implantation

The Mode Selection Trial (MOST) in sinus node dysfunction: Design, rationale, and baseline characteristics of the first 1000 patients

2000 ◽  
Vol 140 (4) ◽  
pp. 541-551 ◽  
Author(s):  
Gervasio A. Lamas ◽  
Kerry Lee ◽  
Michael Sweeney ◽  
Angel Leon ◽  
Raymond Yee ◽  
...  
Keyword(s):  
Sinus Node ◽  
Mode Selection ◽  
Sinus Node Dysfunction ◽  
Design Rationale ◽  
Baseline Characteristics

scholarly journals Inadekvát, aránytalan sinuscsomó-tachycardia. Egy régi szívritmuszavar új megvilágításban

2019 ◽  
Vol 160 (37) ◽  
pp. 1464-1470
Author(s):  
József Borbola ◽  
Csaba Földesi ◽  
Attila Kardos ◽  
Zoltán Som
Keyword(s):  
Quality Of Life ◽  
Heart Rate ◽  
Supraventricular Tachycardia ◽  
Sinus Node ◽  
Holter Monitoring ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Inadequate Response ◽  
X Ray ◽  
Chest X Ray

Abstract: Introduction: The inadequate, inappropriate sinus-node tachycardia is not a rare clinical syndrome, defined as a non-paroxysmal, increased sinus-rate at rest, and/or inadequate response to physical and/or emotional stress, and palpitations. Aim: The aim of this study was to describe our experiences with the investigations of our inappropriate sinus-node tachycardia patients. Method: In the last years, 104 patients (92 women, 12 men, mean age: 31 ± 10 years) were treated with this cardiac arrhythmia entity. All patients underwent 12 leads ECG, chest X-ray, echocardiography, Holter-monitoring and transtelephonic ECG observations. The quality of life score was estimated by using the European Heart Rhythm Association scale. Results: Patients had no structural heart disease (physical examination ECG, chest X-ray, echocardiography were normal), the laboratory values (TSH, blood count) were within normal limits, but the resting heart rates were repeatedly high (102 ± 8/min). The results of Holter recording (expressed as minimal-maximal [average] heart rate/min) without drug therapy showed high heart rate values (59 ± 8, 160 ± 14 [94 ± 6]/min). The standard bicycle ergometry showed an average loading capacity of 124 ± 23 watt (heart rate: control: 99 ± 12/min, top: 167 ± 13/min) with early, inadequate sinus tachycardia. To disclose the episodes of paroxysmal supraventricular tachycardia, beside the Holter-monitoring transtelephonic ECG system was used. This diagnostic modality was very useful for the exclusion of paroxysmal supraventricular tachycardia episodes during the palpitation symptoms. Out of 104 patients, 4 patients (3.8%) showed familiar occurrence, another 16 patients (15.2%) had previous slow-pathway radiofrequency ablation due to atrioventricular nodal reentry tachycardia. Conclusions: Based on our clinical observations, it can be pointed out that inappropriate sinus-node tachycardia syndrome (1) occurs mainly in young women, mostly in students, inducing decreased quality of life scores (EHRA score: 2.3 ± 0.4); (2) the prevalence in our outpatient clinic was 0.7%; (3) the patient population is not homogeneous: familiar or postablation occurrence is possible in some patients; (4) transtelephonic ECG has been proved to be very useful to disclose episodes of paroxysmal supraventricular tachycardia in these patients. Orv Hetil. 2019; 160(37): 1464–1470.

scholarly journals 1167-220 Pacing mode and quality of life in the mode selection trial

2004 ◽  
Vol 43 (5) ◽  
pp. A147
Author(s):  
Kirsten E Fleischmann ◽  
E.John Orav ◽  
Gervasio A Lamas ◽  
Carol M Mangione ◽  
Eleanor Schron ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mode Selection ◽  
Pacing Mode

Definitions, clinical presentation, symptoms, quality of life, and patient preferences

ESC CardioMed ◽  
2018 ◽  
pp. 2053-2054
Author(s):  
Tatjana Potpara
Keyword(s):  
Quality Of Life ◽  
Clinical Presentation ◽  
Sinus Node ◽  
Abrupt Onset ◽  
Clinical Syndrome ◽  
Warm Up ◽  
Gradual Onset ◽  
Heart Beating ◽  
Offset Frequency

The term supraventricular tachycardia (SVT) refers to all tachycardias originating from supraventricular tissue (i.e. the sinus node, atria, or atrioventricular junction) or requiring it for their maintenance. Paroxysmal SVT is a clinical syndrome characterized by a tachycardia with an abrupt onset and termination. Non-paroxysmal SVTs have a gradual onset and offset sometimes characterized by the ‘warm-up’ and ‘warm-down’ phenomena. The term incessant is used to describe continuous SVTs, or repetitive SVTs recorded during 90% or more of the monitoring period. Clinical presentation of SVT is heterogeneous, depending on the SVT type, the patient’s age, and underlying comorbidities. Some SVT patients may be asymptomatic or minimally symptomatic. Symptoms related to SVTs include palpitations, lightheadedness, dizziness, diaphoresis, chest discomfort or chest pain, shortness of breath/dyspnoea, anxiety, polyuria, presyncope, and syncope, which may have different causes (cardiogenic syncope, vasovagal reflex syncope, or syncope due to sinus node dysfunction). A detailed appreciation of the SVT pattern (e.g. abrupt or gradual onset/offset), frequency of episodes, duration, symptoms (e.g. regular fast heart beating, or irregular palpitations), and possible triggers may aid the interpretation of the electrocardiogram tracings and definite diagnosis. Although SVTs are generally more common in younger, healthy individuals, a variable disease course may significantly alter the patient’s quality of life. Many SVT patients have insufficient knowledge about their disease and available treatment. Patient education can improve their understanding of the disease and facilitate active participation of patients in the informed, shared decision-making regarding treatment.

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