title: Frequency of atrial tachyarrhythmias in patients treated by cardiac resynchronization (from the Prospective, Multicenter Mona Lisa Study).
abstract: The continuous measurement of sustained atrial tachyarrhythmia (AT) is now possible with some permanently implanted devices. Data on this subject remain controversial. The aim of this study was to evaluate the incidence of sustained AT in patients treated with cardiac resynchronization therapy using pacemakers without backup defibrillators (CRT-P), within the first year after implantation, using strict definition criteria for sustained AT and a systematic review of all high-quality electrographically recorded episodes. The Mona Lisa study was a prospective, multicenter, cohort study carried out from February 2004 to February 2006, with a 12-month follow-up period. Sustained AT was defined as an episode lasting > or =5 minutes; episodes were confirmed by a systematic review of electrograms in the whole study population. Of the 198 patients who underwent CRT-P device implantation and were enrolled in the study, 173 were in stable sinus rhythm at baseline and were included in the analysis (mean age 70 +/- 9 years, 66% men, 91% in New York Heart Association class III, mean QRS duration 164 +/- 26 ms, mean left ventricular ejection fraction 25 +/- 7%). During a mean follow-up period of 9.9 +/- 3.6 months, 34 patients experienced > or =1 episode of sustained AT, for an incidence rate of 27.5% (95% confidence interval 18.2 to 36.7). Only a history of AT was independently associated with the occurrence of sustained AT within the 12 months after CRT-P device implantation (hazard ratio 2.3, 95% confidence interval 1.2 to 4.4, p = 0.02). In conclusion, this first prospective electrogram-based evaluation of AT incidence demonstrated that 27% of patients developed > or =1 episode of sustained AT lasting > or =5 minutes in the 12 months after CRT-P device implantation.
authors: Département de Rythmologie, Toulouse, France. eloi_marijon@yahoo.fr
authors: Eloi
authors: E
authors: Marijon
authors: Sophie
authors: S
authors: Jacob
authors: Elisabeth
authors: E
authors: Mouton
authors: Pascal
authors: P
authors: Defaye
authors: Olivier
authors: O
authors: Piot
authors: Nicolas
authors: N
authors: Delarche
authors: Stéphane
authors: S
authors: Dennetiere
authors: Daniel
authors: D
authors: Galley
authors: Pierre
authors: P
authors: Le Franc
authors: Ursula
authors: U
authors: Appl
authors: Yves
authors: Y
authors: Guyomar
authors: Jean Paul
authors: JP
authors: Albenque
authors: Philippe
authors: P
authors: Chevalier
authors: Serge
authors: S
authors: Boveda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002304:Cardiac Pacing, Artificial; D015331:Cohort Studies; D004554:Electric Countershock; D015716:Electrocardiography, Ambulatory; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D015203:Reproducibility of Results; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D013997:Time Factors