Atrial therapies reduce atrial arrhythmia burden in defibrillator patients

Paul A. Friedman, Barbara Dijkman, Eduardo N. Warman, H. Amy Xia, Rahul Mehra, Marshall S. Stanton, Stephen C. Hammill

Research output: Contribution to journalArticle

137 Scopus citations

Abstract

Background - Approximately 25% of patients who receive an implantable cardioverter-defibrillator (ICD) to treat ventricular tachyarrhythmias have documented atrial tachyarrhythmias before implantation. This study assessed the ability of device-based prevention and termination therapies to reduce the burden of spontaneous atrial tachyarrhythmias. Methods and Results - Patients with a standard indication for the implantation of an ICD and 2 episodes of atrial tachyarrhythmias in the preceding year received a dual-chamber ICD (Medtronic 7250 Jewel AF) that uses pacing and shock therapies for prevention and/or termination of atrial tachyarrhythmias. In a multicenter trial, patients were randomized to 3-month periods with atrial therapies "on" or "off" and subsequently crossed over. Analysis was performed on the 52 of 269 patients who had episodes of atrial tachyarrhythmia and had ≥30 days of follow-up with atrial therapies on and off. The atrial therapies resulted in a reduction of atrial tachyarrhythmia burden from a mean of 58.5 to 7.8 h/mo. A paired analysis (Wilcoxon signed-rank test) showed that the median difference in burden (1.1 h/mo) was highly significant (P=0.007). When the subgroup of 41 patients treated only with atrial pacing therapies was analyzed, the reduction in burden persisted (P=0.01). Conclusions - In this study, patients with a standard ICD indication and atrial tachyarrhythmias had a significant reduction in atrial tachyarrhythmia burden with use of atrial pacing and shock therapies.

Original languageEnglish (US)
Pages (from-to)1023-1028
Number of pages6
JournalCirculation
Volume104
Issue number9
DOIs
StatePublished - Aug 28 2001

Keywords

  • Atrial flutter
  • Atrium
  • Defibrillation
  • Fibrillation
  • Pacing
  • Tachyarrhythmias

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Friedman, P. A., Dijkman, B., Warman, E. N., Xia, H. A., Mehra, R., Stanton, M. S., & Hammill, S. C. (2001). Atrial therapies reduce atrial arrhythmia burden in defibrillator patients. Circulation, 104(9), 1023-1028. https://doi.org/10.1161/hc3401.095039