Do atrial tachyarrhythmias beget ventricular tachyarrhythmias in defibrillator recipients?
Do atrial tachyarrhythmias beget ventricular tachyarrhythmias in defibrillator recipients?
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DOI：
10.1016/s0735-1097(02)01957-5
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发表时间：
2002-07-17
影响因子：
24
通讯作者：
Lerman, BB
中科院分区：
文献类型：
--
作者：
Stein, KM;Euler, DE;Lerman, BB
目的 本研究旨在分析接受双腔植入式心律转复除颤器 (ICD) 的患者中“双室心动过速 (VT) 或心室颤动 (VF) 后继发阵发性房性心动过速 (AT) 或心房颤动 (AF)”的发生率。 背景 阵发性 AT/AF 通常发生在接受 ICD 治疗危及生命的患者中VT/V-F。尽管 AF 与结构性心脏病的不良预后相关，但 AT/AF 与 VT/V-F 之间的关系尚不清楚。 方法 我们对 537 名接受 Jewel AF ICD（型号 7250，美敦力，明尼阿波利斯，明尼苏达州）植入的患者进行了为期 11.4+/-8.2 个月的随访。其中包括 398 名在前一年中至少有两次 AT 或 AF 发作史的患者，以及 139 名仅因 VT/V-F 入组的患者。 结果 45 名患者在随访期间出现了 233 次双重心动过速发作。总体而言，8.9% 的 VT/VF 发作是双重心动过速，20.3% 的 VT/VF 患者至少有一次双重心动过速发作。首次检测到 VT/VF 之前的 AT/AF 持续时间中位数为 1.09 小时（25% 至 75% 四分位数为 0.24 至 33.4 小时）。当 AT/AF 在两次连续 VT/V-F 检测之间持续时，中位检测间隔为 11 分钟。当 AT/AF 由于心室治疗或自发终止时，中位检测间隔延长至 71 小时（p
Objectives This study was designed to analyze the incidence of "dual tachycardia"-ventricular tachycardia (VT) or ventricular fibrillation (VF) preceded by paroxysmal atrial tachycardia (AT) or atrial fibrillation (AF)-in patients receiving dual-chamber implantable cardioverter defibrillators (ICDs).Background Paroxysmal AT/AF occurs commonly in patients who receive ICDs for the treatment of life-threatening VT/V-F. Although AF is associated with an adverse prognosis in the setting of structural heart disease, the relationship between AT/AF and VT/V-F is unclear.Methods We followed 537 patients undergoing implantation of the Jewel AF ICD (Model 7250, Medtronic, Minneapolis, Minnesota) for 11.4+/-8.2 months. These included 398 patients with a history of at least two episodes of AT or AF during the preceding year as well as 139 patients enrolled because of VT/V-F alone.Results There were 233 dual tachycardia episodes in 45 patients during follow-up. Overall, 8.9% of episodes detected as VT/VF were dual tachycardias, and 20.3% of patients with VT/VF had at least one dual tachycardia episode. The median duration of AT/AF preceding the first VT/VF detection was 1.09 h (25% to 75% quartile 0.24 to 33.4 h). When AT/AF continued between two consecutive VT/V-F detections, the median interdetection interval was 11 min. When AT/AF terminated either because of a ventricular therapy or spontaneously, the median interdetection interval was prolonged to 71 h (p