Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 1999
Mode switching in dual chamber pacemakers: effect of onset criteria on arrhythmia-related symptoms.
Клиническое исследованиеСтатьяРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Marshall H J, Kay G N, Hess M, Plumb V J, Bubien R S, Hummel J, Dawson D, Markewitz T, Gammage M D
Аннотация
AIMS: Various mode-switching algorithms are available with different tachyarrhythmia detection criteria to be satisfied to initiate mode-switching. This study evaluated three different mode-switching algorithms in patients with paroxysmal atrial fibrillation.
METHODS AND RESULTS: Seventeen patients completed the study. Three mode-switching algorithms were downloaded as software into the pacemaker, each for 1 month in a single-blind, randomized sequence. The criteria to initiate mode-switching were: mean atrial rate ('standard'), '4-of-7' or '1-of-1' atrial intervals to exceed the atrial detection rate. Symptoms for each were measured using the Symptom Checklist Frequency and Severity index. The median number of mode-switch episodes increased from 20 for 'standard' to 39 for '4-of-7' (P=0.029 vs 'standard') and 103 for '1-of-1' (P=0.0012 vs 'standard') onset criteria. Median duration of episodes decreased from 2.5 min with 'standard' to 1.4 min with '4-of-7' and 0.4 min with '1-of-1' onset criteria. Frequency of symptoms was lower using '4-of-7' (18.2 +/- 12.0 vs 23 +/- 12.0, P=0.08) or '1-of-1' (20.4 +/- 12.4 vs 23 +/- 12.0, P=0.07) than 'standard' onset criteria. Severity of arrhythmia tended to be less with either '4-of-7' (16 +/- 10.4 vs 19.1 +/- 19.4, P=0.12) or '1-of-1' (17.5 +/- 10.3 vs 19.1 +/- 9.4, P=0.18) than with 'standard' onset criteria.
CONCLUSIONS: The more sensitive onset criteria for detection of atrial tachyarrhythmias were associated with lower frequency and severity of symptoms.
METHODS AND RESULTS: Seventeen patients completed the study. Three mode-switching algorithms were downloaded as software into the pacemaker, each for 1 month in a single-blind, randomized sequence. The criteria to initiate mode-switching were: mean atrial rate ('standard'), '4-of-7' or '1-of-1' atrial intervals to exceed the atrial detection rate. Symptoms for each were measured using the Symptom Checklist Frequency and Severity index. The median number of mode-switch episodes increased from 20 for 'standard' to 39 for '4-of-7' (P=0.029 vs 'standard') and 103 for '1-of-1' (P=0.0012 vs 'standard') onset criteria. Median duration of episodes decreased from 2.5 min with 'standard' to 1.4 min with '4-of-7' and 0.4 min with '1-of-1' onset criteria. Frequency of symptoms was lower using '4-of-7' (18.2 +/- 12.0 vs 23 +/- 12.0, P=0.08) or '1-of-1' (20.4 +/- 12.4 vs 23 +/- 12.0, P=0.07) than 'standard' onset criteria. Severity of arrhythmia tended to be less with either '4-of-7' (16 +/- 10.4 vs 19.1 +/- 19.4, P=0.12) or '1-of-1' (17.5 +/- 10.3 vs 19.1 +/- 9.4, P=0.18) than with 'standard' onset criteria.
CONCLUSIONS: The more sensitive onset criteria for detection of atrial tachyarrhythmias were associated with lower frequency and severity of symptoms.