Saverio Iacopino, Ezio Santobuono, Claudia Amellone, Antonio Rapacciuolo, Carlo Lavalle, Carmelo La Greca, Luca Santini, Matteo Bertini, Giovanni Statuto, Mariolina Lovecchio, Sergio Valsecchi, Vincenzo Tavoletta
BackgroundThe programing of subcutaneous implantable cardioverter‐defibrillators (S‐ICD) in clinical practice has been little studied, as the activation status of the SMART Pass filter, which was implemented to reduce inappropriate shocks.PurposeWe assessed device programing during follow‐up and the rate of detected arrhythmias in consecutive S‐ICD recipients.MethodsWe analyzed data from 670 S‐ICD patients followed on the remote network at 17 Italian centers for a median of 31 months (25th–75th percentile: 16–51). The enhanced SMART Pass version, introduced in October 2022, was expected to reduce the unintentional deactivation rate.ResultsAt the latest remote data transmission, the median conditional zone cut‐off was set to 210 bpm (25th–75th percentile: 200–220), the shock zone cutoff was 250 bpm (25th–75th percentile: 240–250), and the SMART Pass was enabled in 586 (87%) patients. During follow‐up, 194 automatic deactivation events were reported in 118 (18%) patients. Shocks were delivered in 129 (19%) patients, and untreated arrhythmias were recorded in 136 (20%) patients. The rate of shocks was lower when SMART Pass was enabled ‐0.12/patient‐year (95% CI: 0.10–0.14) versus 0.20 (95% CI: 0.15–0.26) (p = .002), as it was the rate of untreated arrhythmias ‐0.12/patient‐year (95% CI: 0.11–0.14) versus 0.23 (95% CI: 0.18–0.30) (p = .001). The enhanced SMART Pass version was associated with a lower rate of deactivations ‐0.04/patient‐year (95% CI: 0.02–0.05) versus 0.14 (95% CI: 0.12–0.16) (p < .001), and with a reduction in treated and untreated arrhythmias (Incidence rate ratios: 0.40 (95% CI: 0.28–0.53) and 0.40 (95% CI: 0.30–0.55), respectively (p < .001)).ConclusionsCenters tend to program devices to detect high ventricular rates for arrhythmia detection, to minimize inappropriate shock occurrences. SMART Pass activation is associated with lower rates of detected and treated arrhythmias. The enhanced SMART Pass version seems associated with a lower deactivation rate and with a further decrease in treated arrhythmias.
{"title":"Device programing and SMART pass algorithm activation in subcutaneous implantable defibrillator patients: Data from a remote monitoring database","authors":"Saverio Iacopino, Ezio Santobuono, Claudia Amellone, Antonio Rapacciuolo, Carlo Lavalle, Carmelo La Greca, Luca Santini, Matteo Bertini, Giovanni Statuto, Mariolina Lovecchio, Sergio Valsecchi, Vincenzo Tavoletta","doi":"10.1111/pace.15049","DOIUrl":"https://doi.org/10.1111/pace.15049","url":null,"abstract":"BackgroundThe programing of subcutaneous implantable cardioverter‐defibrillators (S‐ICD) in clinical practice has been little studied, as the activation status of the SMART Pass filter, which was implemented to reduce inappropriate shocks.PurposeWe assessed device programing during follow‐up and the rate of detected arrhythmias in consecutive S‐ICD recipients.MethodsWe analyzed data from 670 S‐ICD patients followed on the remote network at 17 Italian centers for a median of 31 months (25th–75th percentile: 16–51). The enhanced SMART Pass version, introduced in October 2022, was expected to reduce the unintentional deactivation rate.ResultsAt the latest remote data transmission, the median conditional zone cut‐off was set to 210 bpm (25th–75th percentile: 200–220), the shock zone cutoff was 250 bpm (25th–75th percentile: 240–250), and the SMART Pass was enabled in 586 (87%) patients. During follow‐up, 194 automatic deactivation events were reported in 118 (18%) patients. Shocks were delivered in 129 (19%) patients, and untreated arrhythmias were recorded in 136 (20%) patients. The rate of shocks was lower when SMART Pass was enabled ‐0.12/patient‐year (95% CI: 0.10–0.14) versus 0.20 (95% CI: 0.15–0.26) (<jats:italic>p</jats:italic> = .002), as it was the rate of untreated arrhythmias ‐0.12/patient‐year (95% CI: 0.11–0.14) versus 0.23 (95% CI: 0.18–0.30) (<jats:italic>p</jats:italic> = .001). The enhanced SMART Pass version was associated with a lower rate of deactivations ‐0.04/patient‐year (95% CI: 0.02–0.05) versus 0.14 (95% CI: 0.12–0.16) (<jats:italic>p</jats:italic> < .001), and with a reduction in treated and untreated arrhythmias (Incidence rate ratios: 0.40 (95% CI: 0.28–0.53) and 0.40 (95% CI: 0.30–0.55), respectively (<jats:italic>p</jats:italic> < .001)).ConclusionsCenters tend to program devices to detect high ventricular rates for arrhythmia detection, to minimize inappropriate shock occurrences. SMART Pass activation is associated with lower rates of detected and treated arrhythmias. The enhanced SMART Pass version seems associated with a lower deactivation rate and with a further decrease in treated arrhythmias.","PeriodicalId":19650,"journal":{"name":"Pacing and Clinical Electrophysiology","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141783483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BackgroundIdentification of infrequent nonpulmonary vein trigger premature atrial contractions (PACs) is challenging. We hypothesized that pace mapping (PM) assessed by correlation scores calculated by an intracardiac pattern matching (ICPM) module was useful for locating PAC origins, and conducted a validation study to assess the accuracy of ICPM‐guided PM.MethodsAnalyzed were 30 patients with atrial fibrillation. After pulmonary vein isolation, atrial pacing was performed at one or two of four sites on the anterior and posterior aspects of the left atrium (LA, n = 10/10), LA septum (n = 10), and lateral RA (n = 10), which was arbitrarily determined as PAC. The intracardiac activation obtained from each pacing was set as an ICPM reference consisting of six CS unipolar electrograms (CS group) or six CS unipolar electrograms and four RA electrograms (CS–RA group).ResultsThe PM was performed at 193 ± 107 sites for each reference pacing site. All reference pacing sites corresponded to sites where the maximal ICPM correlation score was obtained. Sites with a correlation score ≥98% were rarely obtained in the CS‐RA than CS group (33% vs. 55%, P = .04), but those ≥95% were similarly obtained between the two groups (93% vs. 88%, P = .71), and those ≥90% were obtained in all. The surface areas with correlation scores ≥98% (0[0,10] vs. 10[0,35] mm2, P = .02), ≥95% (10[10,30] vs. 50[10,180] mm2, P = .002) and ≥90% (60[30,100] vs. 170[100,560] mm2, P = .0002) were smaller in the CS‐RA than CS group.ConclusionsICPM‐guided PM was useful for identifying the reference pacing sites. Combined use of RA and CS electrograms may improve the mapping quality.
背景识别不常见的非肺静脉触发的房性早搏（PAC）具有挑战性。我们假设，通过心内模式匹配（ICPM）模块计算的相关性评分评估的起搏图（PM）有助于定位 PAC 起源，并进行了一项验证研究以评估 ICPM 引导的起搏图的准确性。肺静脉隔离后，在左心房（LA，n = 10/10）、LA 间隔（n = 10）和 RA 外侧（n = 10）四个部位中的一个或两个进行心房起搏，任意确定为 PAC。每次起搏获得的心内激活被设定为ICPM参考，包括6个CS单极电图（CS组）或6个CS单极电图和4个RA电图（CS-RA组）。所有参考起搏部位都与获得最大 ICPM 相关性评分的部位相对应。CS-RA组相关性评分≥98%的部位比CS组少（33% vs. 55%，P = .04），但两组相关性评分≥95%的部位相似（93% vs. 88%，P = .71），两组相关性评分≥90%的部位都有。相关性评分≥98%（0[0,10] vs. 10[0,35] mm2，P = .02）、≥95%（10[10,30] vs. 50[10,180] mm2，P = .002）和≥90%（60[30,100] vs. 170[100,560] mm2，P = .0002）的表面积在 CS-RA 组小于 CS 组。联合使用 RA 和 CS 电图可提高绘图质量。
{"title":"A validation study of the accuracy of the atrial pace map assessed with intracardiac pattern matching: Potential utility of non‐pulmonary vein mapping","authors":"Yuji Wakamatsu, Koichi Nagashima, Satoshi Hayashida, Ryuta Watanabe, Shu Hirata, Moyuru Hirata, Masanaru Sawada, Sayaka Kurokawa, Yasuo Okumura","doi":"10.1111/pace.15030","DOIUrl":"https://doi.org/10.1111/pace.15030","url":null,"abstract":"BackgroundIdentification of infrequent nonpulmonary vein trigger premature atrial contractions (PACs) is challenging. We hypothesized that pace mapping (PM) assessed by correlation scores calculated by an intracardiac pattern matching (ICPM) module was useful for locating PAC origins, and conducted a validation study to assess the accuracy of ICPM‐guided PM.MethodsAnalyzed were 30 patients with atrial fibrillation. After pulmonary vein isolation, atrial pacing was performed at one or two of four sites on the anterior and posterior aspects of the left atrium (LA, <jats:italic>n</jats:italic> = 10/10), LA septum (<jats:italic>n</jats:italic> = 10), and lateral RA (<jats:italic>n</jats:italic> = 10), which was arbitrarily determined as PAC. The intracardiac activation obtained from each pacing was set as an ICPM reference consisting of six CS unipolar electrograms (CS group) or six CS unipolar electrograms and four RA electrograms (CS–RA group).ResultsThe PM was performed at 193 ± 107 sites for each reference pacing site. All reference pacing sites corresponded to sites where the maximal ICPM correlation score was obtained. Sites with a correlation score ≥98% were rarely obtained in the CS‐RA than CS group (33% vs. 55%, <jats:italic>P</jats:italic> = .04), but those ≥95% were similarly obtained between the two groups (93% vs. 88%, <jats:italic>P</jats:italic> = .71), and those ≥90% were obtained in all. The surface areas with correlation scores ≥98% (0[0,10] vs. 10[0,35] mm<jats:sup>2</jats:sup>, <jats:italic>P</jats:italic> = .02), ≥95% (10[10,30] vs. 50[10,180] mm<jats:sup>2</jats:sup>, <jats:italic>P</jats:italic> = .002) and ≥90% (60[30,100] vs. 170[100,560] mm<jats:sup>2</jats:sup>, <jats:italic>P</jats:italic> = .0002) were smaller in the CS‐RA than CS group.ConclusionsICPM‐guided PM was useful for identifying the reference pacing sites. Combined use of RA and CS electrograms may improve the mapping quality.","PeriodicalId":19650,"journal":{"name":"Pacing and Clinical Electrophysiology","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141502107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BackgroundTachycardia‐induced cardiomyopathy (TIC) is a reversible cardiomyopathy with ventricular dysfunction caused by tachyarrhythmias. Notably, atrial fibrillation (AF) is the most common causal arrhythmia leading to TIC. However, the risk factors for the development of TIC due to AF remain unclear. This study aimed to identify the associated factors of TIC due to AF.MethodsPersistent AF patients with heart rate (HR) ≥100 beats per minute who underwent initial catheter ablation were enrolled in this study. TIC was diagnosed as left ventricular ejection fraction (LVEF) < 50% during AF rhythm, which was recovered after the restoration of sinus rhythm. Non‐TIC was defined as LVEF ≥ 50% despite AF rhythm. The patient backgrounds were compared between the TIC group and the non‐TIC group to reveal the contributing factors of TIC.ResultsThe TIC group comprised 57 patients, while the non‐TIC group consisted of 101 patients. The TIC group was younger than the non‐TIC group (median 64 vs. 70, p = 0.006). Male sex was more frequent in the TIC group than the non‐TIC group (82.5% vs. 58.4%, p = 0.003). HR was higher in the TIC group than in the non‐TIC group (median 130 bpm vs. 111 bpm, p < 0.001). The number of smokers was significantly higher in the TIC group than in the non‐TIC group (p < 0.001). Multivariable analysis demonstrated that higher HR (odds ratio [OR]: 1.74; 95% confidence interval [CI]: 1.37–2.21; p < 0.001) and current smokers (OR: 5.27; 95% CI: 1.60–17.4; p = 0.006) were the independent factors leading to TIC.ConclusionHigher HR and current smokers were independent risk factors for the development of TIC due to AF.
{"title":"Risk factors for tachycardia‐induced cardiomyopathy due to atrial fibrillation","authors":"Koji Yasumoto, Yasuyuki Egami, Hiroaki Nohara, Shodai Kawanami, Hiroki Sugae, Kohei Ukita, Akito Kawamura, Hitoshi Nakamura, Masaki Tsuda, Naotaka Okamoto, Yasuharu Matsunaga‐Lee, Masamichi Yano, Masami Nishino, Jun Tanouchi","doi":"10.1111/pace.15026","DOIUrl":"https://doi.org/10.1111/pace.15026","url":null,"abstract":"BackgroundTachycardia‐induced cardiomyopathy (TIC) is a reversible cardiomyopathy with ventricular dysfunction caused by tachyarrhythmias. Notably, atrial fibrillation (AF) is the most common causal arrhythmia leading to TIC. However, the risk factors for the development of TIC due to AF remain unclear. This study aimed to identify the associated factors of TIC due to AF.MethodsPersistent AF patients with heart rate (HR) ≥100 beats per minute who underwent initial catheter ablation were enrolled in this study. TIC was diagnosed as left ventricular ejection fraction (LVEF) < 50% during AF rhythm, which was recovered after the restoration of sinus rhythm. Non‐TIC was defined as LVEF ≥ 50% despite AF rhythm. The patient backgrounds were compared between the TIC group and the non‐TIC group to reveal the contributing factors of TIC.ResultsThe TIC group comprised 57 patients, while the non‐TIC group consisted of 101 patients. The TIC group was younger than the non‐TIC group (median 64 vs. 70, <jats:italic>p</jats:italic> = 0.006). Male sex was more frequent in the TIC group than the non‐TIC group (82.5% vs. 58.4%, <jats:italic>p</jats:italic> = 0.003). HR was higher in the TIC group than in the non‐TIC group (median 130 bpm vs. 111 bpm, <jats:italic>p</jats:italic> < 0.001). The number of smokers was significantly higher in the TIC group than in the non‐TIC group (<jats:italic>p</jats:italic> < 0.001). Multivariable analysis demonstrated that higher HR (odds ratio [OR]: 1.74; 95% confidence interval [CI]: 1.37–2.21; <jats:italic>p</jats:italic> < 0.001) and current smokers (OR: 5.27; 95% CI: 1.60–17.4; <jats:italic>p</jats:italic> = 0.006) were the independent factors leading to TIC.ConclusionHigher HR and current smokers were independent risk factors for the development of TIC due to AF.","PeriodicalId":19650,"journal":{"name":"Pacing and Clinical Electrophysiology","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141524521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, significantly impacting patients' quality of life and increasing the risk of death, stroke, heart failure, and dementia. Over the past two decades, there have been significant breakthroughs in AF risk prediction and screening, stroke prevention, rhythm control, catheter ablation, and integrated management. During this period, the scale, quality, and experience of AF management in China have greatly improved, providing a solid foundation for the development of the guidelines for the diagnosis and management of AF. To further promote standardized AF management, and apply new technologies and concepts to clinical practice timely and fully, the Chinese Society of Cardiology of Chinese Medical Association and the Heart Rhythm Committee of Chinese Society of Biomedical Engineering jointly developed the Chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation. The guidelines comprehensively elaborated on various aspects of AF management and proposed the CHA2DS2‑VASc‑60 stroke risk score based on the characteristics of the Asian AF population. The guidelines also reevaluated the clinical application of AF screening, emphasized the significance of early rhythm control, and highlighted the central role of catheter ablation in rhythm control.
{"title":"Chinese guidelines for the diagnosis and management of atrial fibrillation","authors":"Changsheng Ma, Shulin Wu, Shaowen Liu, Yaling Han","doi":"10.1111/pace.14920","DOIUrl":"https://doi.org/10.1111/pace.14920","url":null,"abstract":"Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, significantly impacting patients' quality of life and increasing the risk of death, stroke, heart failure, and dementia. Over the past two decades, there have been significant breakthroughs in AF risk prediction and screening, stroke prevention, rhythm control, catheter ablation, and integrated management. During this period, the scale, quality, and experience of AF management in China have greatly improved, providing a solid foundation for the development of the guidelines for the diagnosis and management of AF. To further promote standardized AF management, and apply new technologies and concepts to clinical practice timely and fully, the Chinese Society of Cardiology of Chinese Medical Association and the Heart Rhythm Committee of Chinese Society of Biomedical Engineering jointly developed the <jats:italic>Chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation</jats:italic>. The guidelines comprehensively elaborated on various aspects of AF management and proposed the CHA<jats:sub>2</jats:sub>DS<jats:sub>2</jats:sub>‑VASc‑60 stroke risk score based on the characteristics of the Asian AF population. The guidelines also reevaluated the clinical application of AF screening, emphasized the significance of early rhythm control, and highlighted the central role of catheter ablation in rhythm control.","PeriodicalId":19650,"journal":{"name":"Pacing and Clinical Electrophysiology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although ventricular capture during the atrial threshold test is possible, there are rare reports on the insulation defect and inactive leads thereof. In this case, we present a pacemaker‐dependent patient with a history of pacemaker generator replacements. The patient experienced ventricular capture induced by atrial pacing due to adhesion of the atrial and ventricular leads with an insulation defect. The atrial lead was abandoned and a new lead was implanted. However, there was a significant decrease in ventricular impedance detected shortly after the new lead was implanted. When observing the phenomenon of atrial pacing‐induced ventricular depolarization, one uncommon reason to consider is lead adhesive wear. It is important to pay attention to the contact and bending sites of the leads.
{"title":"Beware of atrial pacing‐induced ventricular depolarization: A case of lead malfunction","authors":"Bailing Dai, Wenqing Yin, Chengming Ma, Peipei Ma, Yingqi Wang, Li Hong, Xiaohong Yu, Xiaomeng Yin, Yingxue Dong, Yunlong Xia, Yanzong Yang, Lianjun Gao","doi":"10.1111/pace.14993","DOIUrl":"https://doi.org/10.1111/pace.14993","url":null,"abstract":"Although ventricular capture during the atrial threshold test is possible, there are rare reports on the insulation defect and inactive leads thereof. In this case, we present a pacemaker‐dependent patient with a history of pacemaker generator replacements. The patient experienced ventricular capture induced by atrial pacing due to adhesion of the atrial and ventricular leads with an insulation defect. The atrial lead was abandoned and a new lead was implanted. However, there was a significant decrease in ventricular impedance detected shortly after the new lead was implanted. When observing the phenomenon of atrial pacing‐induced ventricular depolarization, one uncommon reason to consider is lead adhesive wear. It is important to pay attention to the contact and bending sites of the leads.","PeriodicalId":19650,"journal":{"name":"Pacing and Clinical Electrophysiology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140834135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Is it effective SGLT2 inhibitors for every AF patients?","authors":"Halit Emre Yalvaç, Erdi Babayiğit, Bülent Görenek","doi":"10.1111/pace.14991","DOIUrl":"https://doi.org/10.1111/pace.14991","url":null,"abstract":"","PeriodicalId":19650,"journal":{"name":"Pacing and Clinical Electrophysiology","volume":"97 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christian Toquica, Mohammad‐Ali Jazayeri, Amit Noheria, Loren Berenbom, Martin Emert, Rhea Pimentel, Raghu Dendi, Y. Madhu Reddy, Seth H. Sheldon
IntroductionCatheter ablation (CA) can interfere with cardiac implantable electronic device (CIED) function. The safety of CA in the 1st year after CIED implantation/lead revision is uncertain.MethodsThis single center, retrospective cohort included patients who underwent CA between 2012 and 2017 and had a CIED implant/lead revision within the preceding year. We assessed the frequency of device/lead malfunctions in this population.ResultsWe identified 1810 CAs in patients between 2012 and 2017, with 170 CAs in 163 patients within a year of a CIED implant/lead revision. Mean age 68 ± 12 years (68% men). Time between the CIED procedure and CA was 158 ± 99 days. The CA procedures included AF ablation (n = 57, 34%), AV node ablation (n = 40, 24%), SVT ablation (n = 37, 22%), and PVC/VT ablations (n = 36, 21%). The cumulative frequency of lead dislodgement, significant CIED dysfunction, and/or CIED‐related infection following CA was (n = 1/170, 0.6%). There was a single atrial lead dislodgement (0.6%). There were no instances of power‐on‐reset or CIED‐related infection. Following CA, there was no significant difference in RA or RV lead sensing (p = 0.52 and 0.84 respectively) or thresholds (p = 0.94 and 0.17 respectively). The RA impedance slightly decreased post‐CA from 474 ± 80 Ohms to 460 ± 73 Ohms (p = 0.002), as did the RV impedance (from 515 ± 111 Ohms to 497 ± 98 Ohms, p < 0.0001).ConclusionsCA can be performed within 1 year following CIED implantation/lead revision with a low risk of CIED/lead malfunction or lead dislodgement. The ideal time to perform CA after a CIED remains uncertain.
{"title":"Safety of catheter ablation in patients with recently implanted cardiac implantable electronic device: A 5‐year experience","authors":"Christian Toquica, Mohammad‐Ali Jazayeri, Amit Noheria, Loren Berenbom, Martin Emert, Rhea Pimentel, Raghu Dendi, Y. Madhu Reddy, Seth H. Sheldon","doi":"10.1111/pace.14987","DOIUrl":"https://doi.org/10.1111/pace.14987","url":null,"abstract":"IntroductionCatheter ablation (CA) can interfere with cardiac implantable electronic device (CIED) function. The safety of CA in the 1st year after CIED implantation/lead revision is uncertain.MethodsThis single center, retrospective cohort included patients who underwent CA between 2012 and 2017 and had a CIED implant/lead revision within the preceding year. We assessed the frequency of device/lead malfunctions in this population.ResultsWe identified 1810 CAs in patients between 2012 and 2017, with 170 CAs in 163 patients within a year of a CIED implant/lead revision. Mean age 68 ± 12 years (68% men). Time between the CIED procedure and CA was 158 ± 99 days. The CA procedures included AF ablation (<jats:italic>n</jats:italic> = 57, 34%), AV node ablation (<jats:italic>n</jats:italic> = 40, 24%), SVT ablation (<jats:italic>n </jats:italic>= 37, 22%), and PVC/VT ablations (<jats:italic>n</jats:italic> = 36, 21%). The cumulative frequency of lead dislodgement, significant CIED dysfunction, and/or CIED‐related infection following CA was (<jats:italic>n</jats:italic> = 1/170, 0.6%). There was a single atrial lead dislodgement (0.6%). There were no instances of power‐on‐reset or CIED‐related infection. Following CA, there was no significant difference in RA or RV lead sensing (<jats:italic>p</jats:italic> = 0.52 and 0.84 respectively) or thresholds (<jats:italic>p</jats:italic> = 0.94 and 0.17 respectively). The RA impedance slightly decreased post‐CA from 474 ± 80 Ohms to 460 ± 73 Ohms (<jats:italic>p</jats:italic> = 0.002), as did the RV impedance (from 515 ± 111 Ohms to 497 ± 98 Ohms, <jats:italic>p</jats:italic> < 0.0001).ConclusionsCA can be performed within 1 year following CIED implantation/lead revision with a low risk of CIED/lead malfunction or lead dislodgement. The ideal time to perform CA after a CIED remains uncertain.","PeriodicalId":19650,"journal":{"name":"Pacing and Clinical Electrophysiology","volume":"279 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140804761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samuel H. Baldinger, Désirée Burren, Fabian Noti, Helge Servatius, Jens Seiler, Antonio Madaffari, Babken Asatryan, Hildegard Tanner, Tobias Reichlin, Andreas Haeberlin, Laurent Roten
AimsPacemaker (PM) patients may require a subsequent upgrade to an implantable cardioverter defibrillator (ICD). Limited data exists on this patient population. We sought to characterize this population, to assess predictors for ICD upgrade, and to report the outcome.MethodsFrom our prospective PM and ICD implantation registry, all patients who underwent PM and/or ICD implantations at our center were analyzed. Patient characteristics and outcomes of PM patients with subsequent ICD upgrade were compared to age‐ and sex‐matched patients with de novo ICD implantation, and to PM patients without subsequent upgrade.ResultsOf 1′301 ICD implantations, 60 (5%) were upgraded from PMs. Median time from PM implantation to ICD upgrade was 2.6 years (IQR 1.3‐5.4). Of 2′195 PM patients, 28 patients underwent subsequent ICD upgrades, corresponding to an estimated annual incidence of an ICD upgrade of at least 0.33%. Lower LVEF (p = .05) and male sex (p = .038) were independent predictors for ICD upgrade. Survival without death, transplant and LVAD implantation were worse both for upgraded ICD patients compared to matched patients with de novo ICD implantation (p = .05), as well as for PM patients with subsequent upgrade compared to matched PM patients not requiring an upgrade (p = .036).ConclusionsOne of 20 ICD implantations are upgrade of patients with a PM. At least one of 30 PM patients will require an ICD upgrade in the following 10 years. Predictors for ICD upgrade are male sex and lower LVEF at PM implantation. Upgraded patients have worse outcomes.
{"title":"Patient characteristics, predictors and outcome of pacemaker patients upgraded to an implantable cardioverter defibrillator","authors":"Samuel H. Baldinger, Désirée Burren, Fabian Noti, Helge Servatius, Jens Seiler, Antonio Madaffari, Babken Asatryan, Hildegard Tanner, Tobias Reichlin, Andreas Haeberlin, Laurent Roten","doi":"10.1111/pace.14988","DOIUrl":"https://doi.org/10.1111/pace.14988","url":null,"abstract":"AimsPacemaker (PM) patients may require a subsequent upgrade to an implantable cardioverter defibrillator (ICD). Limited data exists on this patient population. We sought to characterize this population, to assess predictors for ICD upgrade, and to report the outcome.MethodsFrom our prospective PM and ICD implantation registry, all patients who underwent PM and/or ICD implantations at our center were analyzed. Patient characteristics and outcomes of PM patients with subsequent ICD upgrade were compared to age‐ and sex‐matched patients with de novo ICD implantation, and to PM patients without subsequent upgrade.ResultsOf 1′301 ICD implantations, 60 (5%) were upgraded from PMs. Median time from PM implantation to ICD upgrade was 2.6 years (IQR 1.3‐5.4). Of 2′195 PM patients, 28 patients underwent subsequent ICD upgrades, corresponding to an estimated annual incidence of an ICD upgrade of at least 0.33%. Lower LVEF (<jats:italic>p</jats:italic> = .05) and male sex (<jats:italic>p</jats:italic> = .038) were independent predictors for ICD upgrade. Survival without death, transplant and LVAD implantation were worse both for upgraded ICD patients compared to matched patients with de novo ICD implantation (<jats:italic>p</jats:italic> = .05), as well as for PM patients with subsequent upgrade compared to matched PM patients not requiring an upgrade (<jats:italic>p</jats:italic> = .036).ConclusionsOne of 20 ICD implantations are upgrade of patients with a PM. At least one of 30 PM patients will require an ICD upgrade in the following 10 years. Predictors for ICD upgrade are male sex and lower LVEF at PM implantation. Upgraded patients have worse outcomes.","PeriodicalId":19650,"journal":{"name":"Pacing and Clinical Electrophysiology","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140804529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：