TY - JOUR
T1 - Can we predict new AF occurrence in single-chamber ICD patients? Insights from an observational investigation
AU - Biffi, Mauro
AU - Ziacchi, Matteo
AU - Ricci, Renato Pietro
AU - Facchin, Domenico
AU - Morani, Giovanni
AU - Landolina, Maurizio
AU - Lunati, Maurizio
AU - Iacopino, Saverio
AU - Capucci, Alessandro
AU - Bianchi, Stefano
AU - Infusino, Tommaso
AU - Botto, Giovanni Luca
AU - Padeletti, Luigi
AU - Boriani, Giuseppe
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background Atrial tachyarrhythmias (AT/AF) have been associated with an increased risk of mortality, morbidity and ischemic stroke. Up to now, single chamber ICD diagnostics was not able to detect AT/AF, therefore the incidence of new onset AT/AF in patients with single chamber ICD is not known. Objective To evaluate incidence and predictors of AT/AF occurrence in patients with dual-chamber ICD with no pacing indications and no history of AT/AF that strictly mimic single chamber ICD recipient. Methods & results Consecutive dual-chamber ICD patients were prospectively followed by 47 Italian cardiologic centers in an observational research. Clinical and device data were reviewed by expert cardiologists to assess AT/AF occurrence. Multivariate regression analysis evaluated the risk of new-onset AT/AF and its association with patients’ baseline characteristics and with CHADS2 score. 428 (13.4% female, 64 years old) patients were followed for a median observation period of 31 months. AT/AF episodes occurred in 160 (37.4%) patients when considering at least 5 min duration, in 95 (22.2%) for AT/AF ≥ 6 h, in 47 (11.0%) for AT/AF ≥ 1 day, in 29 (6.8%) for AT/AF ≥ 7 days. Patients with CHADS2 ≥ 2, who comprised 36% of the whole population, showed higher incidence of AT/AF ≥ 6 h compared with patients with CHADS2 < 2 (Hazard Ratio = 1.69, 95% Confidence Interval = 1.13–2.53, p = 0.011). Conclusions Our observations in a population of dual-chamber ICD patients with no pacing indications and no history of AT/AF, who strictly mimic single–chamber ICD recipients, highlight that AT/AF episodes occurred in the 37.5% of the population and CHADS2 score is predictive of new-onset AT/AF.
AB - Background Atrial tachyarrhythmias (AT/AF) have been associated with an increased risk of mortality, morbidity and ischemic stroke. Up to now, single chamber ICD diagnostics was not able to detect AT/AF, therefore the incidence of new onset AT/AF in patients with single chamber ICD is not known. Objective To evaluate incidence and predictors of AT/AF occurrence in patients with dual-chamber ICD with no pacing indications and no history of AT/AF that strictly mimic single chamber ICD recipient. Methods & results Consecutive dual-chamber ICD patients were prospectively followed by 47 Italian cardiologic centers in an observational research. Clinical and device data were reviewed by expert cardiologists to assess AT/AF occurrence. Multivariate regression analysis evaluated the risk of new-onset AT/AF and its association with patients’ baseline characteristics and with CHADS2 score. 428 (13.4% female, 64 years old) patients were followed for a median observation period of 31 months. AT/AF episodes occurred in 160 (37.4%) patients when considering at least 5 min duration, in 95 (22.2%) for AT/AF ≥ 6 h, in 47 (11.0%) for AT/AF ≥ 1 day, in 29 (6.8%) for AT/AF ≥ 7 days. Patients with CHADS2 ≥ 2, who comprised 36% of the whole population, showed higher incidence of AT/AF ≥ 6 h compared with patients with CHADS2 < 2 (Hazard Ratio = 1.69, 95% Confidence Interval = 1.13–2.53, p = 0.011). Conclusions Our observations in a population of dual-chamber ICD patients with no pacing indications and no history of AT/AF, who strictly mimic single–chamber ICD recipients, highlight that AT/AF episodes occurred in the 37.5% of the population and CHADS2 score is predictive of new-onset AT/AF.
KW - Atrial fibrillation
KW - Atrial fibrillation diagnosis, single chamber defibrillator
KW - CHADS score
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U2 - 10.1016/j.ijcard.2016.12.126
DO - 10.1016/j.ijcard.2016.12.126
M3 - Article
AN - SCOPUS:85009486494
VL - 230
SP - 275
EP - 280
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -