Incidence of paroxysmal atrial tachycardias in patients treated with cardiac resynchronization therapy and continuously monitored by device diagnostics

C. Leclercq, L. Padeletti, R. Cihák, P. Ritter, G. Milasinovic, D. Gras, V. Paul, I. C. Van Gelder, C. Stellbrink, G. Rieger, G. Corbucci, B. Albers, J. C. Daubert

Research output: Contribution to journalArticle

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Abstract

Aims Little is known about the incidence of paroxysmal atrial tachycardias (PAT) in patients with heart failure (HF). The availability of cardiac resynchronization therapy (CRT) devices with extended diagnostics for AT enables continuous monitoring of PAT episodes. The aim of the study was to assess the incidence over time of PAT in HF patients treated with CRT.Methods and resultsConsecutive patients in NYHA functional class III or IV despite optimal drug therapy, QRS duration ≥130 ms, left ventricular ejection fraction ≤35%, and left ventricular end-diastolic dimension ≥55 mm were eligible for enrolment. Patients with permanent or persistent atrial fibrillation (AF) were not included in the study. The first follow-up examination was performed 2 weeks after implantation, to optimize atrial sensing and CRT. Subsequent follow-up examinations were carried out 15 and 28 weeks after implantation, to collect the telemetric data. A total of 173 patients (67 ± 11 years, M 116) were enrolled. Complete arrhythmia monitoring data were available from 120 patients over a mean follow-up of 183 ± 23 days. Atrial tachycardia episodes were detected through telemetry in 25 of 120 patients (21%) during at least one follow-up examination. Atrial tachycardia episodes were recorded in 29 and 17% (P = NS) of patients with and without previous history of AF, respectively.ConclusionMore than 20% of the overall HF patient population treated with CRT suffer PAT episodes. Paroxysmal atrial tachycardia may interfere with response to CRT. Therefore, telemetric data may be relevant to drive the appropriate therapy in each patient.

Original languageEnglish
Pages (from-to)71-77
Number of pages7
JournalEuropace
Volume12
Issue number1
DOIs
Publication statusPublished - Jan 2010

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Paroxysmal Tachycardia
Cardiac Resynchronization Therapy
Equipment and Supplies
Incidence
Heart Failure
Tachycardia
Atrial Fibrillation
Cardiac Resynchronization Therapy Devices
Telemetry
Stroke Volume
Cardiac Arrhythmias

Keywords

  • Atrial fibrillation
  • Biventricular pacing
  • CRT
  • Heart failure
  • Pacemaker
  • Paroxysmal atrial tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Incidence of paroxysmal atrial tachycardias in patients treated with cardiac resynchronization therapy and continuously monitored by device diagnostics. / Leclercq, C.; Padeletti, L.; Cihák, R.; Ritter, P.; Milasinovic, G.; Gras, D.; Paul, V.; Van Gelder, I. C.; Stellbrink, C.; Rieger, G.; Corbucci, G.; Albers, B.; Daubert, J. C.

In: Europace, Vol. 12, No. 1, 01.2010, p. 71-77.

Research output: Contribution to journalArticle

Leclercq, C, Padeletti, L, Cihák, R, Ritter, P, Milasinovic, G, Gras, D, Paul, V, Van Gelder, IC, Stellbrink, C, Rieger, G, Corbucci, G, Albers, B & Daubert, JC 2010, 'Incidence of paroxysmal atrial tachycardias in patients treated with cardiac resynchronization therapy and continuously monitored by device diagnostics', Europace, vol. 12, no. 1, pp. 71-77. https://doi.org/10.1093/europace/eup318
Leclercq, C. ; Padeletti, L. ; Cihák, R. ; Ritter, P. ; Milasinovic, G. ; Gras, D. ; Paul, V. ; Van Gelder, I. C. ; Stellbrink, C. ; Rieger, G. ; Corbucci, G. ; Albers, B. ; Daubert, J. C. / Incidence of paroxysmal atrial tachycardias in patients treated with cardiac resynchronization therapy and continuously monitored by device diagnostics. In: Europace. 2010 ; Vol. 12, No. 1. pp. 71-77.
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abstract = "Aims Little is known about the incidence of paroxysmal atrial tachycardias (PAT) in patients with heart failure (HF). The availability of cardiac resynchronization therapy (CRT) devices with extended diagnostics for AT enables continuous monitoring of PAT episodes. The aim of the study was to assess the incidence over time of PAT in HF patients treated with CRT.Methods and resultsConsecutive patients in NYHA functional class III or IV despite optimal drug therapy, QRS duration ≥130 ms, left ventricular ejection fraction ≤35{\%}, and left ventricular end-diastolic dimension ≥55 mm were eligible for enrolment. Patients with permanent or persistent atrial fibrillation (AF) were not included in the study. The first follow-up examination was performed 2 weeks after implantation, to optimize atrial sensing and CRT. Subsequent follow-up examinations were carried out 15 and 28 weeks after implantation, to collect the telemetric data. A total of 173 patients (67 ± 11 years, M 116) were enrolled. Complete arrhythmia monitoring data were available from 120 patients over a mean follow-up of 183 ± 23 days. Atrial tachycardia episodes were detected through telemetry in 25 of 120 patients (21{\%}) during at least one follow-up examination. Atrial tachycardia episodes were recorded in 29 and 17{\%} (P = NS) of patients with and without previous history of AF, respectively.ConclusionMore than 20{\%} of the overall HF patient population treated with CRT suffer PAT episodes. Paroxysmal atrial tachycardia may interfere with response to CRT. Therefore, telemetric data may be relevant to drive the appropriate therapy in each patient.",
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AU - Leclercq, C.

AU - Padeletti, L.

AU - Cihák, R.

AU - Ritter, P.

AU - Milasinovic, G.

AU - Gras, D.

AU - Paul, V.

AU - Van Gelder, I. C.

AU - Stellbrink, C.

AU - Rieger, G.

AU - Corbucci, G.

AU - Albers, B.

AU - Daubert, J. C.

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N2 - Aims Little is known about the incidence of paroxysmal atrial tachycardias (PAT) in patients with heart failure (HF). The availability of cardiac resynchronization therapy (CRT) devices with extended diagnostics for AT enables continuous monitoring of PAT episodes. The aim of the study was to assess the incidence over time of PAT in HF patients treated with CRT.Methods and resultsConsecutive patients in NYHA functional class III or IV despite optimal drug therapy, QRS duration ≥130 ms, left ventricular ejection fraction ≤35%, and left ventricular end-diastolic dimension ≥55 mm were eligible for enrolment. Patients with permanent or persistent atrial fibrillation (AF) were not included in the study. The first follow-up examination was performed 2 weeks after implantation, to optimize atrial sensing and CRT. Subsequent follow-up examinations were carried out 15 and 28 weeks after implantation, to collect the telemetric data. A total of 173 patients (67 ± 11 years, M 116) were enrolled. Complete arrhythmia monitoring data were available from 120 patients over a mean follow-up of 183 ± 23 days. Atrial tachycardia episodes were detected through telemetry in 25 of 120 patients (21%) during at least one follow-up examination. Atrial tachycardia episodes were recorded in 29 and 17% (P = NS) of patients with and without previous history of AF, respectively.ConclusionMore than 20% of the overall HF patient population treated with CRT suffer PAT episodes. Paroxysmal atrial tachycardia may interfere with response to CRT. Therefore, telemetric data may be relevant to drive the appropriate therapy in each patient.

AB - Aims Little is known about the incidence of paroxysmal atrial tachycardias (PAT) in patients with heart failure (HF). The availability of cardiac resynchronization therapy (CRT) devices with extended diagnostics for AT enables continuous monitoring of PAT episodes. The aim of the study was to assess the incidence over time of PAT in HF patients treated with CRT.Methods and resultsConsecutive patients in NYHA functional class III or IV despite optimal drug therapy, QRS duration ≥130 ms, left ventricular ejection fraction ≤35%, and left ventricular end-diastolic dimension ≥55 mm were eligible for enrolment. Patients with permanent or persistent atrial fibrillation (AF) were not included in the study. The first follow-up examination was performed 2 weeks after implantation, to optimize atrial sensing and CRT. Subsequent follow-up examinations were carried out 15 and 28 weeks after implantation, to collect the telemetric data. A total of 173 patients (67 ± 11 years, M 116) were enrolled. Complete arrhythmia monitoring data were available from 120 patients over a mean follow-up of 183 ± 23 days. Atrial tachycardia episodes were detected through telemetry in 25 of 120 patients (21%) during at least one follow-up examination. Atrial tachycardia episodes were recorded in 29 and 17% (P = NS) of patients with and without previous history of AF, respectively.ConclusionMore than 20% of the overall HF patient population treated with CRT suffer PAT episodes. Paroxysmal atrial tachycardia may interfere with response to CRT. Therefore, telemetric data may be relevant to drive the appropriate therapy in each patient.

KW - Atrial fibrillation

KW - Biventricular pacing

KW - CRT

KW - Heart failure

KW - Pacemaker

KW - Paroxysmal atrial tachycardia

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