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30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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34. Public Health and Health Economics
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Long-term stability of atrial sensing in implantable cardioverter-defibrillators with floating atrial dipole leads
Session:
Posters (Sessão 4 - Écran 4) - Taquicardia ventricular e morte súbita cardíaca
Speaker:
Inês Ferreira Neves
Congress:
CPC 2023
Topic:
C. Arrhythmias and Device Therapy
Theme:
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Subtheme:
08.7 Ventricular Arrhythmias and SCD - Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Inês Ferreira Neves; Bárbara Lacerda Teixeira; Guilherme Portugal; Pedro Silva Cunha; Bruno Valente; Ana Lousinha; Paulo Osório; Helder Santos; André Monteiro; Susana Covas; Rita Contins; Rui Cruz Ferreira; Mário Martins Oliveira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,sans-serif"><span style="color:black"><strong>Introduction</strong>: </span><span style="color:#222222">To maintain the advantages of having atrial sensing without the need to implant an additional lead, a single-lead ICD system with a floating atrial dipole (VDD DX ICD, Biotronik) with active fixation to the right ventricle</span><span style="color:black"> has been developed. In this generation of ICDs, specially filtered atrial signs may be high enough to allow early detection of atrial arrhythmias and improve discrimination between atrial and ventricular tachycardias. However, maintaining reliable and stable atrial sensing via the floating dipole could be a concern regarding this technology. We aimed to determine the long-term stability of atrial sensing in patients (P) with this type of device.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,sans-serif"><span style="color:black"><strong>Methods</strong>: All P implanted with ICDs with an active fixation DX lead at our centre between 2013 and 2021 were included. Atrial sensing and ventricular or supraventricular arrhythmic events were recorded during follow-up. We retrospectively analysed the atrial sensing evolution and compared it with a control group that had been implanted with a VDD pacemaker (PM).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,sans-serif"><span style="color:black"><strong>Results:</strong> Seventy DX ICD P (82.9% males, age 69</span><span style="color:black">±</span><span style="color:black">14 years [between 19 and 86], 81.4% implanted as primary prevention) with > 1-year follow-up were included. The control group included 52P (age 82</span><span style="color:black">±6.3 years) who underwent PM implantation due to an advanced atrioventricular block. The mean P-wave amplitude at implantation was 4.85±2.44 mV in the DX ICD group and 1.54±0.89 mV in the VDD PM group. At one year after implantation, P-wave amplitude was 4.26±2.68 mV in the DX ICD group and 1.20±1.16 mV in the control group.</span><span style="color:black"> From the control group, 7P (15,6%) lost atrial sensing after one year of follow-up, having their PM programmed as VVI after that. None of the P in the ICD group had lost atrial sensing in the same time period. After one year of follow-up, the P-wave amplitude had a mean reduction of 41.3% in the DX ICD group and of 65% in the control group (P=0.05).<strong> </strong></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,sans-serif"><span style="color:black"><strong>Conclusions</strong>: Atrial signals can be reliably sensed by the floating dipole rings of a DX ICD in a long-term follow-up. This technology resulted in a</span><span style="color:black"> higher </span><span style="color:black">stability of atrial sensing when compared with that obtained in P with a VDD PM. Additionally, a noteworthy number of P with a VDD PM lost atrial sensing, which did not happen in the group with the DX ICD. </span></span></span></span></p>
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