Single vs dual chamber icd

Single vs dual chamber icd

Conclusions and relevance: Among patients receiving an ICD for primary prevention without indications for pacing, the use of a dual-chamber device compared with a single-chamber device was associated with a higher risk of device-related complications and similar 1-year mortality and hospitalization outcomes. Reasons for preferentially using dual-chamber ICDs in this setting remains blogger.com by:  · Theoretically, dual-chamber (DC)-ICDs are better rhythm discriminators than single-chamber (SC)-ICDs. However, the ultimate contributions of an additional lead to analyse the atrial endocardial signals, compared with those of a single ventricular lead, remain a matter of debate. Furthermore, the atrial lead is an additional intracardiac foreign body, which increases the costs and Cited by: 24 Dual-chamber ICDs provide dual-chamber pacing, diagnostics for atrial fibrillation (AF), and supraventricular tachycardia (SVT)-VT discriminators that are not available in single-chamber ICDs. Dual-chamber stored EGMs provide higher diagnostic accuracy than single-chamber EGMs. 8 Disadvantages of dual-chamber ICDs include higher cost, atrial lead complication, and decreased

dual vs single chamber ICD | blogger.comesan MD

The opinions expressed in this article are not necessarily those of the Editors of Europace or of the Single vs dual chamber icd Society of Cardiology. Valentina Kutyifa, Dominic A.

Theuns, single vs dual chamber icd, Questioning the preference for dual- vs. Defaye et al, single vs dual chamber icd. Everything should be made single vs dual chamber icd simple as possible, but not simpler.

The clinical value of the implantable cardioverter-defibrillator ICD for the primary prevention of sudden cardiac death has been proven in selected patients with ischaemic or non-ischaemic cardiomyopathy.

The majority of patients enrolled in these randomized trials evaluating ICD efficacy received single-chamber devices. The addition of an atrial lead in dual-chamber ICDs may offer theoretical benefits over single-chamber devices, including enhanced arrhythmia discrimination algorithms, reduction in inappropriate shocks, and the potential to reduce the rate of hospitalization and mortality.

On the contrary, the placement of an atrial lead may involve a longer procedure time and higher risk of complications. It is in this context that the study by Defaye et al, single vs dual chamber icd. in this issue of EP-Europace is of particular interest. They demonstrated that perioperative complications were more frequent The higher rate of perioperative complications with dual-chamber devices corroborates with previous findings from the National Cardiovascular Data Registry NCDR ICD of the U.

and a Canadian retrospective cohort study. The findings of this study have important clinical implications. In current clinical practice, dual-chamber devices are often placed for enhanced arrhythmia discrimination between supraventricular and ventricular tachyarrhythmias to prevent inappropriate shocks. However, a meta-analysis demonstrated that the proportion of patients experiencing inappropriate ICD therapy was not different between single- and dual-chamber devices.

The Multicenter Automatic Defibrillator Implantation Trial: Reduce Inappropriate Therapy MADIT-RIT indicated that novel programming with either a high-rate cut-off 2, single vs dual chamber icd. In MADIT-RIT, only dual-chamber ICD devices were implanted; however, it is conceivable that the potential benefit of enhanced arrhythmia discrimination algorithms to reduce inappropriate therapy in dual-chamber ICDs becomes marginal for arrhythmias over bpm, especially with prolonged detection time.

Data from MADIT-II suggest that inappropriate ICD therapies culminate in heart rate zones below bpm. Although MADIT-RIT did not include patients with single-chamber ICD devices, a recent sub-study from Multicenter Automatic Defibrillator Implantation Trial: Cardiac Resynchronization Therapy MADIT-CRT may shed further lights on the very question Defaye et al.

Ruwald et al. reported data on rates of inappropriate ICD therapy, single vs dual chamber icd, complications, and hospitalizations in single-chamber ICD patients and dual-chamber ICD patients. single-chamber ICD groups. The current study by Defaye et al. Imposing additional morbidity with an increased complication rate, however, did not increase all-cause mortality, or cardiovascular mortality in this subgroup.

Interestingly, there was a higher incidence of battery depletion in the dual-chamber ICD group compared with the single-chamber ICD patients, indicating potentially higher risk of infections and pocket haematomas in the long-term, not even mentioning related costs.

The findings by Defaye et al. Class I and IIa indications for cardiac pacing, device programming, procedure time and potential confounders e. right ventricular pacing percentage in the present study and may present with potential selection bias. In contrast, real-life registries are essential to extend general applicability of findings of randomized clinical trials.

In summary, the data presented by Defaye et al. Dual-chamber devices do not appear to offer clinical benefit over single-chamber devices with single vs dual chamber icd to all-cause mortality and prevention of inappropriate ICD shocks. dual-chamber ICD to improve survival without an increase in perioperative complications or frequent device replacements. Theuns DASmith THunink MGBardy GHJordaens L.

Effectiveness of prophylactic implantation of cardioverter-defibrillators without cardiac resynchronization therapy in patients with ischaemic or non-ischaemic heart disease: a systematic review and meta-analysis. Europace ; 12 : — Google Scholar. Priori SGBlomström-Lundqvist CMazzanti ABlom NBorggrefe MCamm J et al. Europace ; 17 : — Defaye PBoveda SKlug DBeganton FPiot ONarayanan K et al.

Dual- vs, single vs dual chamber icd. single-chamber defibrillators for primary prevention of sudden cardiac death: long-term follow-up of the Défibrillateur Automatique Implantable—Prévention Primaire registry. Europace ; 19 : — Lee DSKrahn ADHealey JSBirnie DCrystal EDorian P et al. Evaluation of early complications related to de novo cardioverter defibrillator implantation insights from the Ontario ICD database.

J Am Coll Cardiol ; 55 : — Peterson PNVarosy PDHeidenreich PAWang YDewland TACurtis JP et al. Association of single- vs dual-chamber ICDs with mortality, readmissions, and complications among patients receiving an Single vs dual chamber icd for primary prevention. JAMA ; : — Theuns DARivero-Ayerza MBoersma EJordaens L.

Prevention of inappropriate therapy in implantable defibrillators: a meta-analysis of clinical trials comparing single-chamber and dual-chamber arrhythmia discrimination algorithms. Int J Cardiol ; : — 7. Moss AJSchuger CBeck CABrown MWCannom DSsingle vs dual chamber icd, Daubert JP et al.

Reduction in inappropriate therapy and mortality through ICD programming, single vs dual chamber icd. N Single vs dual chamber icd J Med ; : — Ruwald ACSood NRuwald MHJons CClyne CAMcNitt S et al. Frequency of inappropriate therapy in patients implanted with dual- versus single-chamber ICD devices in the ICD arm of MADIT-CRT.

J Cardiovasc Electrophysiol ; 24 : — 9. Friedman PABradley DKoestler CSlusser JHodge DBailey K et al. A prospective randomized trial of single- or dual-chamber implantable cardioverter-defibrillators to minimize inappropriate shock risk in primary sudden single vs dual chamber icd death prevention.

Europace ; 16 : — 8. Thygesen LCErsboll AK. When the entire population is the sample: strengths and limitations in register-based epidemiology. Eur J Epidemiol ; 29 : — 8. Oxford University Press is a department of the University of Oxford.

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Close mobile search navigation Article Navigation. Volume Article Contents Funding. Article Navigation. Questioning the preference for dual- vs. single-chamber implantable defibrillator in primary prevention implantable cardioverter-defibrillator recipients Valentina KutyifaValentina Kutyifa.

Oxford Academic. Dominic A. E-mail address: d. theuns erasmusmc. PDF Split View Views. Cite Cite Valentina Kutyifa, Dominic A. Select Format Select format. ris Mendeley, Papers, Zotero. enw EndNote. bibtex BibTex. txt Medlars, RefWorks Download citation. Permissions Icon Permissions. Close search filter This issue All EP Europace All ESC Family All Journals search input Search. Albert Einstein. Google Scholar Crossref. Search ADS. Google Scholar PubMed. OpenURL Placeholder Text. Google Scholar OpenURL Placeholder Text.

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 · Peterson PN, Varosy PD, Heidenreich PA, et al. Association of Single- vs Dual-Chamber ICDs With Mortality, Readmissions, and Complications Among Patients Receiving an ICD for Primary Prevention. JAMA. doi/jama eFigure. Distribution of propensity scores for receipt of dual chamber device among singleand dual-chamber groupsCited by: Icd Vs Pacemaker - Single Vs Dual Chamber Icd - prikaztn. It also contains a computer that tracks your heart rate and rhythm. Pacemaker & icd are two different devices. The main difference is that if. Icd vs pacemaker statistički, ubojica broj jedan je bolest srca. —— all icds have a pacemaker function  · Dual-chamber devices do not appear to offer clinical benefit over single-chamber devices with regard to all-cause mortality and prevention of inappropriate ICD shocks. Such findings warrant careful assessment of potential risks/benefits of dual-chamber ICD implantations in at-risk cardiac patients without Class I or IIa pacing indications, to select the best ICD treatment (single- vs. dual-chamber ICD) Author: Valentina Kutyifa, Dominic A M J Theuns