© 2001 by European Society of Cardiology
REGULAR ARTICLES
Indications for dual-chamber cardioverter defibrillators at implant and at 1 year follow-up: a retrospective analysis in the single-chamber defibrillator era
1Ospedale S.Maria della Misericordia Fondazione I.R.C.A.B. Udine, Italy; 2Centro Cardiologico Università di Milano, Italy; 3Ospedale Niguarda Milano, Italy; 4Ospedale Maggiore Trieste, Italy
AIM: This retrospective four-centre study assessed the current indications for dual-chamber implantable cardioverter defibrillators (ICDs) at implant and during a medium-term follow-up period in a group of patients treated by single-chamber ICD in the pre dual-chamber ICD era.
METHODS AND RESULTS: The study population consisted of 153 consecutive patients (127 males, mean age 58±6 years) treated by single-chamber ICD for ventricular tachycardia and/or ventricular fibrillation. Definite indications for having a dual-chamber ICD included the presence of sinus node dysfunction and of second- or third-degree atrioventricular (AV) block, while possible indications were represented by paroxysmal atrial fibrillation or flutter and first-degree AV block. At implant, dual-chamber ICD would appear definitely indicated in 10·5% of cases, and possibly indicated in an additional 17·5% of cases. During 12±10 months follow-up, such percentages remained stable (11 and 19·5%, respectively). Inappropriate ICD intervention was documented in five of 13 patients (38%), with episodes of paroxysmal atrial 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 ICD indications. The 15% cumulative incidence of paroxysmal atrial tachyarrhythmias justifies the activation of dedicated detection algorithms.
Key Words: Implantable cardioverter defibrillator, dual-chamber pacing
Correspondence: Dr Alessandro Proclemer, Istituto di Cardiologia, Ospedale S. Maria della Misericordia, Piazzale S. Maria della Misericordia, n. 15. 33100 Udine, Italy.
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