Can we predict new AF occurrence in single-chamber ICD patients? Insights from an observational investigation

Mauro Biffi, Matteo Ziacchi, Renato Pietro Ricci, Domenico Facchin, Giovanni Morani, Maurizio Landolina, Maurizio Lunati, Saverio Iacopino, Alessandro Capucci, Stefano Bianchi, Tommaso Infusino, Giovanni Luca Botto, Luigi Padeletti, Giuseppe Boriani

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)275-280
Number of pages6
JournalInternational Journal of Cardiology
Volume230
DOIs
Publication statusPublished - Mar 1 2017

Keywords

  • Atrial fibrillation
  • Atrial fibrillation diagnosis, single chamber defibrillator
  • CHADS score

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

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