title: Incidence and rate characteristics of atrial tachyarrhythmias in patients with a dual chamber defibrillator.
abstract: Atrial tachyarrhythmias play an important role in the treatment of patients with malignant ventricular tachyarrhythmias not only with respect to inappropriate discharges but also to left ventricular function and stroke risk. A combined dual chamber defibrillator provides separate therapies for atrial and ventricular tachyarrhythmias. To assess the incidence of atrial tachyarrhythmias in patients with this dual chamber implantable defibrillator, 40 patients with ventricular tachyarrhythmias and concomitant atrial tachyarrhythmias and/or AV conduction disturbances were included in a prospective study. During a mean follow-up of 25 +/- 11 months, 26 of 40 patients had a total of 1,430 recurrences of atrial tachyarrhythmias. The vast majority of the atrial tachyarrhythmias with regular atrial cycles had a mean median atrial cycle length of 235 +/- 37 ms and a mean duration of 34 +/- 144 minutes. Atrial tachyarrhythmias with irregular atrial cycles exhibited a median atrial cycle length of 198 +/- 31 ms and had a mean duration of 246 +/- 1,264 minutes. In addition, 67% of 375 tachyarrhythmias, in which the median ventricular cycle length during the ongoing episode could be documented, had a ventricular rate <100 beats/min. Continuous atrial arrhythmia detection with a dual chamber ICD reveals a high incidence of atrial tachyarrhythmias with a predominantly short duration of paroxysmal recurrences <1 hour in the vast majority of episodes.
authors.affiliation: Department of Cardiology, University of Bonn, Bonn, Germany. christian.wolpert@med.ma.uni-heidelberg.de
authors.forename: Christian
authors.initials: C
authors.lastname: Wolpert
authors.forename: Werner
authors.initials: W
authors.lastname: Jung
authors.forename: Susanne
authors.initials: S
authors.lastname: Spehl
authors.forename: Rainer
authors.initials: R
authors.lastname: Schimpf
authors.forename: Heyder
authors.initials: H
authors.lastname: Omran
authors.forename: Burghard
authors.initials: B
authors.lastname: Schumacher
authors.forename: Bahman
authors.initials: B
authors.lastname: Esmailzadeh
authors.forename: Dirk
authors.initials: D
authors.lastname: Tenzer
authors.forename: Rahul
authors.initials: R
authors.lastname: Mehra
authors.forename: Berndt
authors.initials: B
authors.lastname: Lüderitz
mesh_terms: D000465:Algorithms; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence