Indications for dual-chamber cardioverter defibrillators at implant and at1 year follow-up: a retrospective analysis in the single-chamber defibrillator era
A. Proclemer et al., Indications for dual-chamber cardioverter defibrillators at implant and at1 year follow-up: a retrospective analysis in the single-chamber defibrillator era, EUROPACE, 3(2), 2001, pp. 132-135
Aim This retrospective four-centre study assessed the current indications f
or dual-chamber implantable carctioverter defibrillators (ICDs) at implant
and during a medium-term follow-up period in a roup of patients treated by
single-chamber ICD in the pre dual-chamber ICD era.
Methods and Results The study population consisted of 153 consecutive patie
nts (127 males, mean age 58 +/- 6 years) treated by single-chamber ICD for
ventricular tachycardia and/or ventricular fibrillation. Definite indicatio
ns for having a dual-chamber ICD included the presence of sinus node dysfun
ction and of second- or third-degree atrioventricular (AV) block, while pos
sible indications were represented by paroxysmal atrial fibrillation or flu
tter and first-degree AV block. At implant, dual-chamber ICD would appear d
efinitely indicated in 10.5% of cases, and possibly indicated in an additio
nal 17.5% of cases. During 12+/-10 months follow-up, such percentages remai
ned stable (11 and 19.5%, respectively). Inappropriate ICD intervention was
documented in five of 13 patients (38%), with episodes of paroxysmal atria
l fibrillation or flutter.
Conclusion In this non-selected study population, a dual-chamber ICD would
have potentially benefited approximately 30% of the patients. During medium
-term follow-up, there was no progression towards increasing dual-chamber I
CD indications. The 15% cumulative incidence of paroxysmal atrial tachyarrh
ythmias justifies the activation of dedicated detection algorithms. (Europa
ce 2001; 3: 132-135) (C) 2001 The European Society of Cardiology.