Document Detail


Improved detection and analysis of sensed and paced events in dual chamber pacemakers with extended memory function. A prospective multicenter trial in 626 patients.
MedLine Citation:
PMID:  11258107     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PATIENTS AND METHODS: This prospective study analyzed the incidence of atrial arrhythmias in a population of 626 patients in 173 medical centers of eleven European countries and Japan with indication for a dual chamber pacemaker system. The accuracy of the new Automatic Interpretation for Diagnosis Assistance (AIDA) program which is included in Chorus pacemakers was evaluated and the AIDA analysis was compared to and proven with Holter monitoring. Data stored in the pacemakers' memories for the first 24 hours (D1) were compared with simultaneously recorded 24-hour surface electrocardiograms, and data stored over the following 28 days (D28) were examined against reported intercurrent symptoms. RESULTS: At D1, atrial arrhythmias were detected by AIDA in 60 of 626 patients (12%), consisting of atrial fibrillation (n = 29), atrial flutter (n = 4), and miscellaneous arrhythmias (n = 17), and closely corroborated by Holter monitoring (sensitivity 93.7%, specificity 94.9%). At D28, 149 of 386 patients (49%) had had episodes of automatic mode switch prompted by atrial arrhythmias. Symptoms were reported by 81 patients (54%), 92 (62%) had no histories of atrial arrhythmias, and 57 patients (38%) were neither symptomatic nor had histories of atrial arrhythmias. An inverse relationship was found between the number of atrial paced events and the occurrence of atrial arrhythmias (p < 0.001). A history of atrial arrhythmias and older age were associated with a higher risk of atrial arrhythmias (p < 0.05). In contrast, gender, hypertension, concomitant heart disease, or type of atrial lead fixation system were not related with the occurrence of atrial arrhythmias. CONCLUSION: AIDA allowed to confirm, or disprove, the occurrence of atrial arrhythmias as a source of symptoms reported during long-term follow-up. It could also be used to examine the efficacy of antiarrhythmic therapy, and be of assistance when weighing the needs for anticoagulation in patients experiencing asymptomatic atrial arrhythmias.
Authors:
S Sack; E Mouton; P Defaye; N Dagres; U Wolfhard; H Wieneke; J Herrmann; O Oldenburg; A Golles; R Erbel;
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  Herz     Volume:  26     ISSN:  0340-9937     ISO Abbreviation:  Herz     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-03-21     Completed Date:  2001-05-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7801231     Medline TA:  Herz     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  30-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Medical School, University of Essen, Germany. stefan.sack@uni-essen.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Algorithms
Arrhythmias, Cardiac / diagnosis*,  therapy*
Cardiac Pacing, Artificial*
Data Interpretation, Statistical
Diagnosis, Computer-Assisted*
Electrocardiography
Electrocardiography, Ambulatory
Female
Heart Rate
Humans
Male
Microcomputers
Middle Aged
Monitoring, Physiologic
Pacemaker, Artificial*
Prospective Studies
Sensitivity and Specificity
Software

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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