BACKGROUND: The majority of implantable cardioverter defibrillators (ICDs) are dual-chamber devices, but studies on the frequency of inappropriate therapy in dual- versus single-chamber devices have shown conflicting results. The aim of this study is to determine whether implantation of dual-chamber ICD devices decrease the incidence of inappropriate therapy without an unacceptable increase in complications. METHODS: In the ICD arm of the MADIT-CRT study (N = 704), comparisons of single- versus dual-chamber ICD devices were investigated on the endpoints of inappropriate therapy (antitachycardia pacing [ATP] and shocks) and device- and procedure-related complications by use of multivariate Cox proportional hazard regression analysis (hazard ratio dual:single chamber) adjusting for relevant covariates. RESULTS: The frequency of inappropriate therapies in single- and dual-chamber recipients was 41/294 (14%) and 50/410 (12%), respectively. There was no significant difference in overall inappropriate therapy (hazard ratio [HR] = 0.95 [CI: 0.63-1.45], P = 0.95) or inappropriate ATP (HR = 0.98 [CI: 0.61-1.58], P = 0.94), between single- and dual-chamber devices, using single-chamber as a reference (Dual:Single). However, there was a trend toward a decrease in inappropriate shocks (HR = 0.60 [CI: 0.34-1.08], P = 0.09) in the dual-chamber group. The same was evident when only analyzing inappropriate therapy for atrial tachyarrhythmias (HR = 0.88 [CI: 0.56-1.38], P = 0.58). There was no significant difference between the groups in device- or procedure-related complications (HR = 1.54 [CI: 0.82-2.90], P = 0.18). CONCLUSION: No significant difference was found in inappropriate therapy or complications in patients treated with single- versus dual-chamber ICD devices.
BACKGROUND: The majority of implantable cardioverter defibrillators (ICDs) are dual-chamber devices, but studies on the frequency of inappropriate therapy in dual- versus single-chamber devices have shown conflicting results. The aim of this study is to determine whether implantation of dual-chamber ICD devices decrease the incidence of inappropriate therapy without an unacceptable increase in complications. METHODS: In the ICD arm of the MADIT-CRT study (N = 704), comparisons of single- versus dual-chamber ICD devices were investigated on the endpoints of inappropriate therapy (antitachycardia pacing [ATP] and shocks) and device- and procedure-related complications by use of multivariate Cox proportional hazard regression analysis (hazard ratio dual:single chamber) adjusting for relevant covariates. RESULTS: The frequency of inappropriate therapies in single- and dual-chamber recipients was 41/294 (14%) and 50/410 (12%), respectively. There was no significant difference in overall inappropriate therapy (hazard ratio [HR] = 0.95 [CI: 0.63-1.45], P = 0.95) or inappropriate ATP (HR = 0.98 [CI: 0.61-1.58], P = 0.94), between single- and dual-chamber devices, using single-chamber as a reference (Dual:Single). However, there was a trend toward a decrease in inappropriate shocks (HR = 0.60 [CI: 0.34-1.08], P = 0.09) in the dual-chamber group. The same was evident when only analyzing inappropriate therapy for atrial tachyarrhythmias (HR = 0.88 [CI: 0.56-1.38], P = 0.58). There was no significant difference between the groups in device- or procedure-related complications (HR = 1.54 [CI: 0.82-2.90], P = 0.18). CONCLUSION: No significant difference was found in inappropriate therapy or complications in patients treated with single- versus dual-chamber ICD devices.
Authors: Jana Obrova; Eliska Sovova; Eva Kocianova; Milos Taborsky Journal: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub Date: 2021-11-15 Impact factor: 1.648
Authors: Pamela N Peterson; Robert T Greenlee; Alan S Go; David J Magid; Andrea Cassidy-Bushrow; Romel Garcia-Montilla; Karen A Glenn; Jerry H Gurwitz; Stephen C Hammill; John Hayes; Alan Kadish; Kristi Reynolds; Param Sharma; David H Smith; Paul D Varosy; Humberto Vidaillet; Chan X Zeng; Sharon-Lise T Normand; Frederick A Masoudi Journal: J Am Heart Assoc Date: 2017-11-09 Impact factor: 5.501
Authors: George Thomas; Daniel Y Choi; Harish Doppalapudi; Mark Richards; Sei Iwai; Emile G Daoud; Mahmoud Houmsse; Arvindh N Kanagasundram; Sumeet K Mainigi; Steven A Lubitz; Jim W Cheung Journal: J Cardiovasc Electrophysiol Date: 2019-08-05