Overall, the number of implanted dual-chamber devices has been increasing and, according to the AIAC Registry data, accounted for one-third of all the defibrillators implanted in Italy, while single chamber devices made up 39%. The theoretical advantages of dual-chamber ICDs are: better supraventricular tachycardia (SVT) discrimination, optimal treatment of bradyarrhythmias (pre-existing As pacing is rarely necessary in patients with BrS, single-chamber ICDs and S-ICDs are preferred above dual-chamber systems, because of the expected reduced risk of lead-related complications (see Table ). 22 Only a small proportion of patients with BrS will require a device with pacing capabilities, because of the presence of sick sinus syndrome or AV-block, which are also known to be associated The latest guidelines recommend basing the single chamber discrimination on this morphology criterion only. These tracings illustrate the limits of the sudden onset criterion in the diagnosis of an episode of AF. The nominal programming (2/3) with the 3 criteria activated is the cause of several inappropriate therapies when AF becomes regular for a few cycles (sudden onset and regular rhythm in favor of
Single and dual chamber pacing modes | Deranged Physiology
In a nationwide retrospective cohort study involving over 32, such patients, there was no significant difference between patients who received single-chamber devices and those who received dual-chamber devices in 1-year mortality, rate of hospitalization for any cause, single chamber icd pacing, or rate of hospitalization for heart failure, said Dr.
Pamela N. Peterson of the Denver Health Medical Center, and her associates. However, there was an important disadvantage with the dual-chamber ICDs: They carried a higher rate of complications such as infection and lead displacement. They also were more costly than were single-chamber devices because placement is more complex, and time-consuming and later mechanical dysfunction is more common, single chamber icd pacing.
Peterson and her colleagues said. They performed this cohort study because of the "lack of clarity" regarding the long-term safety and outcomes of dual-chamber ICDs compared with single-chamber ICDs. current practice is highly variable," they noted. All of these study subjects received the ICDs for primary prevention only, and none had single chamber icd pacing indications for pacing. The initial data analysis examined rates of any serious complications, including pneumothorax requiring a chest tube within 30 days of the placementhematoma requiring a blood transfusion or evacuation within 30 dayscardiac tamponade within 30 dayslead revision within 90 daysdevice-related infection within 90 daysand recurrent ICD implantation within 90 days.
The unadjusted rate of any such complications were significantly higher with dual-chamber ICDs. The largest difference between single- and dual-chamber devices occurred with the most common complication in this study: mechanical dysfunction of the ICD requiring repeat operation for system revision.
At 1 year, the single chamber icd pacing rates of hospitalization for heart failure The investigators then performed a propensity-matched analysis involving 11, patients who received a single-chamber and the same number who received a dual-chamber ICD. In this analysis, the rate of serious complications also was significantly lower with single-chamber devices 3.
Again, rates of all-cause hospitalization, heart failure hospitalization, and mortality were comparable between the two study groups at 1 year, the investigators said Single chamber icd pacing ; The results remained consistent in further analyses of clinically important subgroups of patients, regardless of age, sex, or the presence or absence of renal dysfunction at the time of operation.
These findings indicate that dual-chamber ICDs "do not appear to offer any clinical benefit" over single-chamber ICDs, at least with regard to death or hospital readmission, Dr, single chamber icd pacing. Peterson and her associates said. Peterson reported no financial conflicts of interest; one of her associates reported receiving grant money from Boston Scientific.
Skip to main content. Single-chamber ICDs better when pacing isn't required. By Mary Single chamber icd pacing Moon. FROM JAMA. Next Article: IOM: Cut daily sodium, but not below 2, mg.
How To Choose Between Single-Chamber and Dual-Chamber ICD | SpringerLink
· Single-chamber ICDs better when pacing isn't required. Publish date: May 14, By Mary Ann Moon. FROM JAMA. Among patients receiving an implantable cardioverter-defibrillator for primary prevention who don’t have indications for pacing, the use of a dual-chamber rather than a single-chamber ICD doesn’t appear to confer any advantage, according to a report in the May 15 · Single chamber ventricular pacing These are pacing modes available to the man who stuck the lead into the right ventricle. This is your only choice if the AV node is screwed, or if you have a useless fibrillating atrium. There is a real disadvantage to this method of pacing The latest guidelines recommend basing the single chamber discrimination on this morphology criterion only. These tracings illustrate the limits of the sudden onset criterion in the diagnosis of an episode of AF. The nominal programming (2/3) with the 3 criteria activated is the cause of several inappropriate therapies when AF becomes regular for a few cycles (sudden onset and regular rhythm in favor of
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