Arrhythmia Detection in Atrioventricular, Single-Lead, Floating Atrial Dipole ICD Systems Compared with Conventional Single- and Dual-Chamber Defibrillators
Background: An atrioventricular defibrillator system with a floating atrial dipole (VDD ICD) can provide atrial sensing by a single lead. Our aim was to compare the arrhythmia detection efficacy of VDD ICDs with conventional single- (VVI) and dual-chamber (DDD) defibrillators. Methods: Data from con...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-12-01
|
| Series: | Journal of Cardiovascular Development and Disease |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2308-3425/11/12/386 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850241002573398016 |
|---|---|
| author | Flora Diana Gausz Kom Nangob Manuela Lena Paul Emmanuel Gedeon Marton Miklos Attila Benak Gabor Bencsik Attila Makai Dora Kranyak Rita Beata Gagyi Robert Pap Laszlo Saghy Tamas Szili-Torok Mate Vamos |
| author_facet | Flora Diana Gausz Kom Nangob Manuela Lena Paul Emmanuel Gedeon Marton Miklos Attila Benak Gabor Bencsik Attila Makai Dora Kranyak Rita Beata Gagyi Robert Pap Laszlo Saghy Tamas Szili-Torok Mate Vamos |
| author_sort | Flora Diana Gausz |
| collection | DOAJ |
| description | Background: An atrioventricular defibrillator system with a floating atrial dipole (VDD ICD) can provide atrial sensing by a single lead. Our aim was to compare the arrhythmia detection efficacy of VDD ICDs with conventional single- (VVI) and dual-chamber (DDD) defibrillators. Methods: Data from consecutive patients undergoing ICD implantation were retrospectively analyzed. The primary endpoint was the incidence of device-detected, new-onset atrial arrhythmias, while secondary endpoints were sensing parameters, complication rates, incidence of appropriate/inappropriate ICD therapy, arrhythmic/heart failure-related hospitalizations, and all-cause mortality. Results: A total of 256 patients (mean age 64 ± 12 years, male 75%, primary prophylaxis 28%, mean follow-up 3.7 ± 2.4 years) were included (VVI: 93, VDD: 94, DDD: 69). Atrial arrhythmia episodes were detected more frequently by VDD systems compared to VVI ICDs (aHR 7.087; 95% CI 2.371–21.183; <i>p</i> < 0.001), and at a rate similar to that of DDD ICDs (aHR 1.781; 95% CI 0.737–4.301; <i>p</i> = 0.200). The rate of inappropriate shocks was not different among the three ICD systems. Conclusion: VDD devices revealed an advantage in atrial arrhythmia detection compared to VVI ICDs and were non-inferior to DDD systems. Their main indication may be closer monitoring in high-risk patients with atrial arrhythmias to help therapy optimization and not the improvement of tachycardia discrimination. |
| format | Article |
| id | doaj-art-93d76bd15e6a4e1c900993e2e6497266 |
| institution | OA Journals |
| issn | 2308-3425 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-93d76bd15e6a4e1c900993e2e64972662025-08-20T02:00:42ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252024-12-01111238610.3390/jcdd11120386Arrhythmia Detection in Atrioventricular, Single-Lead, Floating Atrial Dipole ICD Systems Compared with Conventional Single- and Dual-Chamber DefibrillatorsFlora Diana Gausz0Kom Nangob Manuela Lena1Paul Emmanuel Gedeon2Marton Miklos3Attila Benak4Gabor Bencsik5Attila Makai6Dora Kranyak7Rita Beata Gagyi8Robert Pap9Laszlo Saghy10Tamas Szili-Torok11Mate Vamos12Cardiac Electrophysiology Division, Cardiology Center, Department of Internal Medicine, University of Szeged, 6725 Szeged, HungaryCardiac Electrophysiology Division, Cardiology Center, Department of Internal Medicine, University of Szeged, 6725 Szeged, HungaryCardiac Electrophysiology Division, Cardiology Center, Department of Internal Medicine, University of Szeged, 6725 Szeged, HungaryCardiac Electrophysiology Division, Cardiology Center, Department of Internal Medicine, University of Szeged, 6725 Szeged, HungaryCardiac Electrophysiology Division, Cardiology Center, Department of Internal Medicine, University of Szeged, 6725 Szeged, HungaryCardiac Electrophysiology Division, Cardiology Center, Department of Internal Medicine, University of Szeged, 6725 Szeged, HungaryCardiac Electrophysiology Division, Cardiology Center, Department of Internal Medicine, University of Szeged, 6725 Szeged, HungaryCardiac Electrophysiology Division, Cardiology Center, Department of Internal Medicine, University of Szeged, 6725 Szeged, HungaryCardiac Electrophysiology Division, Cardiology Center, Department of Internal Medicine, University of Szeged, 6725 Szeged, HungaryCardiac Electrophysiology Division, Cardiology Center, Department of Internal Medicine, University of Szeged, 6725 Szeged, HungaryCardiac Electrophysiology Division, Cardiology Center, Department of Internal Medicine, University of Szeged, 6725 Szeged, HungaryCardiac Electrophysiology Division, Cardiology Center, Department of Internal Medicine, University of Szeged, 6725 Szeged, HungaryCardiac Electrophysiology Division, Cardiology Center, Department of Internal Medicine, University of Szeged, 6725 Szeged, HungaryBackground: An atrioventricular defibrillator system with a floating atrial dipole (VDD ICD) can provide atrial sensing by a single lead. Our aim was to compare the arrhythmia detection efficacy of VDD ICDs with conventional single- (VVI) and dual-chamber (DDD) defibrillators. Methods: Data from consecutive patients undergoing ICD implantation were retrospectively analyzed. The primary endpoint was the incidence of device-detected, new-onset atrial arrhythmias, while secondary endpoints were sensing parameters, complication rates, incidence of appropriate/inappropriate ICD therapy, arrhythmic/heart failure-related hospitalizations, and all-cause mortality. Results: A total of 256 patients (mean age 64 ± 12 years, male 75%, primary prophylaxis 28%, mean follow-up 3.7 ± 2.4 years) were included (VVI: 93, VDD: 94, DDD: 69). Atrial arrhythmia episodes were detected more frequently by VDD systems compared to VVI ICDs (aHR 7.087; 95% CI 2.371–21.183; <i>p</i> < 0.001), and at a rate similar to that of DDD ICDs (aHR 1.781; 95% CI 0.737–4.301; <i>p</i> = 0.200). The rate of inappropriate shocks was not different among the three ICD systems. Conclusion: VDD devices revealed an advantage in atrial arrhythmia detection compared to VVI ICDs and were non-inferior to DDD systems. Their main indication may be closer monitoring in high-risk patients with atrial arrhythmias to help therapy optimization and not the improvement of tachycardia discrimination.https://www.mdpi.com/2308-3425/11/12/386ICDimplantable cardioverter defibrillatorfloating atrial sensing dipoleVDDtachycardia discriminationatrial arrythmia detection |
| spellingShingle | Flora Diana Gausz Kom Nangob Manuela Lena Paul Emmanuel Gedeon Marton Miklos Attila Benak Gabor Bencsik Attila Makai Dora Kranyak Rita Beata Gagyi Robert Pap Laszlo Saghy Tamas Szili-Torok Mate Vamos Arrhythmia Detection in Atrioventricular, Single-Lead, Floating Atrial Dipole ICD Systems Compared with Conventional Single- and Dual-Chamber Defibrillators Journal of Cardiovascular Development and Disease ICD implantable cardioverter defibrillator floating atrial sensing dipole VDD tachycardia discrimination atrial arrythmia detection |
| title | Arrhythmia Detection in Atrioventricular, Single-Lead, Floating Atrial Dipole ICD Systems Compared with Conventional Single- and Dual-Chamber Defibrillators |
| title_full | Arrhythmia Detection in Atrioventricular, Single-Lead, Floating Atrial Dipole ICD Systems Compared with Conventional Single- and Dual-Chamber Defibrillators |
| title_fullStr | Arrhythmia Detection in Atrioventricular, Single-Lead, Floating Atrial Dipole ICD Systems Compared with Conventional Single- and Dual-Chamber Defibrillators |
| title_full_unstemmed | Arrhythmia Detection in Atrioventricular, Single-Lead, Floating Atrial Dipole ICD Systems Compared with Conventional Single- and Dual-Chamber Defibrillators |
| title_short | Arrhythmia Detection in Atrioventricular, Single-Lead, Floating Atrial Dipole ICD Systems Compared with Conventional Single- and Dual-Chamber Defibrillators |
| title_sort | arrhythmia detection in atrioventricular single lead floating atrial dipole icd systems compared with conventional single and dual chamber defibrillators |
| topic | ICD implantable cardioverter defibrillator floating atrial sensing dipole VDD tachycardia discrimination atrial arrythmia detection |
| url | https://www.mdpi.com/2308-3425/11/12/386 |
| work_keys_str_mv | AT floradianagausz arrhythmiadetectioninatrioventricularsingleleadfloatingatrialdipoleicdsystemscomparedwithconventionalsingleanddualchamberdefibrillators AT komnangobmanuelalena arrhythmiadetectioninatrioventricularsingleleadfloatingatrialdipoleicdsystemscomparedwithconventionalsingleanddualchamberdefibrillators AT paulemmanuelgedeon arrhythmiadetectioninatrioventricularsingleleadfloatingatrialdipoleicdsystemscomparedwithconventionalsingleanddualchamberdefibrillators AT martonmiklos arrhythmiadetectioninatrioventricularsingleleadfloatingatrialdipoleicdsystemscomparedwithconventionalsingleanddualchamberdefibrillators AT attilabenak arrhythmiadetectioninatrioventricularsingleleadfloatingatrialdipoleicdsystemscomparedwithconventionalsingleanddualchamberdefibrillators AT gaborbencsik arrhythmiadetectioninatrioventricularsingleleadfloatingatrialdipoleicdsystemscomparedwithconventionalsingleanddualchamberdefibrillators AT attilamakai arrhythmiadetectioninatrioventricularsingleleadfloatingatrialdipoleicdsystemscomparedwithconventionalsingleanddualchamberdefibrillators AT dorakranyak arrhythmiadetectioninatrioventricularsingleleadfloatingatrialdipoleicdsystemscomparedwithconventionalsingleanddualchamberdefibrillators AT ritabeatagagyi arrhythmiadetectioninatrioventricularsingleleadfloatingatrialdipoleicdsystemscomparedwithconventionalsingleanddualchamberdefibrillators AT robertpap arrhythmiadetectioninatrioventricularsingleleadfloatingatrialdipoleicdsystemscomparedwithconventionalsingleanddualchamberdefibrillators AT laszlosaghy arrhythmiadetectioninatrioventricularsingleleadfloatingatrialdipoleicdsystemscomparedwithconventionalsingleanddualchamberdefibrillators AT tamasszilitorok arrhythmiadetectioninatrioventricularsingleleadfloatingatrialdipoleicdsystemscomparedwithconventionalsingleanddualchamberdefibrillators AT matevamos arrhythmiadetectioninatrioventricularsingleleadfloatingatrialdipoleicdsystemscomparedwithconventionalsingleanddualchamberdefibrillators |