Long-term reduction of atrial tachyarrhythmia recurrences in patients paced for bradycardia-tachycardia syndrome

Luigi Padeletti, Massimo Santini, Giuseppe Boriani, GianLuca Botto, Michele Gulizia, Giulio Molon, Gianni Luzzi, Gaetano Senatore, Francesco Giraldi, Francesco Zolezzi, Paolo Pieragnoli, Francesco Pro, Tiziana Desanto, Andrea Grammatico, A. Colella, R. Ricci, A. Sagone, M. Biffi, A. Capucci, G. Q. VillaniS. Favale, A. Spampinato, M. Martelli, P. Rizzon, A. Galati, M. Accogli, G. Inama, O. Durin, F. Solimene, F. Coltorti, M. Disertori, M. DelGreco, F. Ferri, A. Vicentini, A. Fusco, P. Della Bella, A. Proclemer, D. Facchin, M. Gasparini, G. Chiaranda, G. Muscio, V. Indelicato, L. Zamperelli, S. DeVivo, V. Spadola, G. Piccione, P. Dini, V. Adinolfi, N. DiGiovanni, V. Guzzo, A. S. Montenero, G. Francese, F. Drago, M. Silvetti, G. Vergara, D. Catanzariti, D. Malfitano, R. Evola, R. Foti, E. Adornato, A. Pangallo, S. Orazi, F. Lisi, A. Copolla, S. Mangiameli, G. Doria, A. Battaglia, O. Pensabene, R. Favilli, W. G. Rahue, M. Tomaino, V. Ziacchi, M. Sassara, C. Puntrello, A. DiGirolamo, L. Vasquez, D. Pecora, A. Circo, A. Tosto, L. Pavia, C. Vasco, A. Battaglia, A. Scirè, M. F. Pasqualini, D. Cornachia, I. Vaccaro, G. Catalano, G. Butera, G. Miranda, O. Bramanti, F. Arrigo, G. DeFabrizio, S. Giglia, M. D'Aulerio, M. Giudice, A. Campana, R. Ferrante, A. Arestia, G. P. Marinoni

Research output: Contribution to journalArticle

Abstract

Background: Atrial tachyarrhythmias (AT) are considered progressive diseases. Several rhythm control therapies for treatment of AT have been proposed. Objectives: The Italian AT500 Registry was designed to prospectively study long-term AT evolution in patients paced for the brady-tachy form of sinus node disease (BT-SND). Methods: Three hundred forty-six BT-SND patients received an antitachycardia dual-chamber pace-maker and were followed-up for a minimum of 12 months (median 19 months). Prevention and antitachycardia pacing (ATP) features were enabled in all patients. Results: During the observation period, 224 (65%) patients were treated by antiarrhythmic drugs and 45 (13%) patients were cardioverted. Five patients suffered a stroke, 4 transient ischemic attack, 22 permanent AT, and 98 AT recurrences longer than 7 days. AT mean cycle length changed from 246 to 2 70 ms, and the percentage of patients with AT-related hospitalizations significantly decreased with an annual 28% relative reduction. AT burden and the percentage of patients with AT recurrences longer than 2 days remained constant with time in the overall population but decreased significantly in the subgroup of patients who did not develop permanent AT. High ATP efficacy was associated with an increasingly higher prevention of AT recurrences longer than 2 days. Conclusion: In a long-term observation of BT-SND patients, AT-related hospitalizations decreased significantly and mean AT cycle length increased significantly. The data suggest that rhythm control therapies induce inversion of AT progression.

Original languageEnglish
Pages (from-to)1047-1057
Number of pages11
JournalHeart Rhythm
Volume2
Issue number10
DOIs
Publication statusPublished - Oct 2005

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Keywords

  • Antiarrhythmic drug
  • Antitachycardia pacing therapy
  • Atrial tachyarrhythmia
  • Prevention algorithm
  • Rhythm control
  • Sinus node disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Padeletti, L., Santini, M., Boriani, G., Botto, G., Gulizia, M., Molon, G., Luzzi, G., Senatore, G., Giraldi, F., Zolezzi, F., Pieragnoli, P., Pro, F., Desanto, T., Grammatico, A., Colella, A., Ricci, R., Sagone, A., Biffi, M., Capucci, A., ... Marinoni, G. P. (2005). Long-term reduction of atrial tachyarrhythmia recurrences in patients paced for bradycardia-tachycardia syndrome. Heart Rhythm, 2(10), 1047-1057. https://doi.org/10.1016/j.hrthm.2005.07.011