Key result
DX ICD detects subclinical AF at comparable rates to standard dual-chamber ICDs.
Why the study?
Comparisons between DX ICDs with an atrial floating dipole and dual-chamber (DDD) ICDs for atrial monitoring are limited in patients without an indication for atrial pacing.
Does the DX ICD provide comparable detection of new-onset device-detected atrial fibrillation compared to standard DDD ICDs in patients without an indication for atrial pacing?
Population
1329 ICD recipients without an indication for atrial pacing
Comparison
DX ICD vs standard DDD ICD
Design
Propensity score-matched observational cohort study
Follow-up
Median 4.5 years
Authors
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Comparable DDAF detection supports DX ICD without atrial lead; leaves open randomized confirmation before practice change.
Cohort (n=1,329)
Yes
Does the DX ICD provide comparable detection of new-onset device-detected atrial fibrillation compared to standard DDD ICDs in patients without an indication for atrial pacing?
p-value: p=≥ 0.36
The DX ICD with a floating atrial dipole provides comparable subclinical atrial fibrillation detection to conventional dual-chamber ICDs in patients without a pacing indication.
Mitacchione et al. (2025) conducted a cohort in Implantable cardioverter-defibrillator recipients without atrial pacing indication (n=1,329). DX ICD (single ventricular lead with floating atrial dipole) vs. Standard dual-chamber (DDD) ICD was evaluated on Incidence of newly detected device-detected subclinical atrial fibrillation (DDAF) at burden cutoffs of ≥ 15 min, ≥ 6 h, and ≥ 24 h (p=≥ 0.36). The DX ICD demonstrated comparable device-detected atrial fibrillation detection rates to standard dual-chamber ICDs after propensity score matching (p ≥ 0.36).
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