P. Defaye et E. Mouton, A new diagnostic concept in cardiac pacing for evaluating the incidence ofatrial arrhythmias: Results of the AIDA study., ARCH MAL C, 92(6), 1999, pp. 719-726
An international, prospective, multicentre trial (AIDA) was undertaken from
October 1995 to March 1997. The object was to compare the diagnosis of atr
ial arrhythmias (AA) by the automatic interpretation of the memory function
s of dual chamber pacemakers with that of 24 hour Holter monitoring at day
1. The second objective was to assess the incidence and symptomatology of t
he AA during follow-up at Day 28.
In France, 226 patients implanted with Chorus,Chorus II and Chorus RM pacem
akers were included in the study (148 men, 70.5 +/- 10.8 years) for the fol
lowing indications : AVB (atrioventricular block)/bundle branch block (47.3
%), sinus mode dysfunction (10.2%), bradycardia-tachycardia syndrome (10.2%
), AVB + sinus node dysfunction + cardia-tachycardia syndrome (19.5%), othe
r (2.2%). AA were documented in 34.5% of patients before implantation.
Of the 226 patients analysed at Day 1, 23 (10.2%) had at least one episode
of AA diagnosed simultaneously by Holter monitoring and the automatic inter
pretation (AIDA). These AA were atrial fibrillation (15 patients), atrial f
lutter (2 patients) and atrial tachycardia (6 patients). The sensitivity of
the AIDA programme for detecting AA was 92% and the specificity 97%. Of th
e 156 patients evaluated at Day 28, the programme diagnosed AA in 78 patien
ts (50%), 34 of which (21.8%) were asymptomatic and without previously docu
mented AA.
The results of the AIDA study confirmed the excellent sensitivity and speci
ficity of the memory functions of these cardiac pacemakers for analysis of
AA. They seem to be very common during the follow-up of pacemaker-equipped
patients. This new diagnostic concept will facilitate the programming and s
tudy of the efficacy of antiarrhythmic therapy prescribed during long-term
follow-up.