Atrial Tachyarrhythmia Recurrence Temporal Patterns in Bradycardia Patients Implanted with Antitachycardia Pacemakers

Renato Ricci, Massimo Santini, Luigi Padeletti, Giuseppe Boriani, Alessandro Capucci, Gianluca Botto, Michele Gulizia, Giuseppe Inama, Antonio Galati, Francesco Solimene, Massimilano Pepe, Andrea Grammatico

Research output: Contribution to journalArticle

Abstract

Introduction: New-generation pacemakers allow continuous atrial tachyarrhythmia (AT) monitoring that provides accurate information about AT type, frequency, burden, and temporary evolution. Methods and Results: We performed a prospective multicenter study to describe AT temporal patterns in patients with sinus bradycardia and AT. Two hundred forty patients (123 men; age 71 ± 8 years) were implanted with a DDDRP pacemaker (model AT500, Medtronic Inc.). All patients were followed for 13 months. The first-month stabilization period of all patients was discarded from analysis. Seventy percent of patients had AT recurrences. Mean time to first AT recurrence (48.2 days, 95% confidence interval [CI] 37.0-59.5 days) was significantly longer than the time between first and second AT episode (10.3 days, 95% CI 6.7-13.9 days, P <0.01). A minority of patients had a uniform time distribution of AT recurrences: 25 AT episodes and fitted by power law and exponential functions. The best fit was obtained by power law function in 60% of patients, by exponential function in 10%, and the two models gave comparable results in 30% of patients. Conclusion: In our population of patients with a history of sinus bradycardia and AT who were implanted with a new device equipped with atrial pacing therapies, 30% did not experience AT recurrences in the 12-month study period. Analysis of interevent time showed that in 60% of patients AT recurrences do not follow a uniform or random distribution. These findings bring into question the use of cross-over design and time to first AT recurrence as a clinical outcome in trials for AT therapy in this patient population.

Original languageEnglish
Pages (from-to)44-51
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume15
Issue number1
DOIs
Publication statusPublished - Jan 2004

Keywords

  • Atrial fibrillation
  • Atrial tachyarrhythmia recurrences
  • Clinical trial design
  • Exponential function
  • Pacemaker
  • Pacing
  • Power law function
  • Statistical modeling

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

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    Ricci, R., Santini, M., Padeletti, L., Boriani, G., Capucci, A., Botto, G., Gulizia, M., Inama, G., Galati, A., Solimene, F., Pepe, M., & Grammatico, A. (2004). Atrial Tachyarrhythmia Recurrence Temporal Patterns in Bradycardia Patients Implanted with Antitachycardia Pacemakers. Journal of Cardiovascular Electrophysiology, 15(1), 44-51. https://doi.org/10.1046/j.1540-8167.2004.03317.x