Key result
An atrial tachyarrhythmia duration of >24 hours in the first year after cardiac resynchronization therapy defibrillator implantation independently predicted subsequent ventricular arrhythmias (HR 2.42).
Why the study?
Atrial tachyarrhythmias are reportedly associated with ventricular arrhythmias, but little is known about the association between atrial tachyarrhythmia duration and the risk of ventricular arrhythmia.
Does a longer duration of atrial tachyarrhythmia increase the risk of subsequent ventricular arrhythmia in patients with a cardiac resynchronization therapy defibrillator?
Cohort (n=160)
No
Does a longer duration of atrial tachyarrhythmia increase the risk of subsequent ventricular arrhythmia in patients with a cardiac resynchronization therapy defibrillator?
In patients with a CRT-D, an atrial tachyarrhythmia duration of >24 hours during the first year post-implantation is an independent predictor of subsequent ventricular arrhythmias.
Answers are grounded in this paper and cite their sources.
Longer ATA duration was associated with VA risk in CRT-D patients; leaves open whether monitoring improves outcomes.
BACKGROUND: Atrial tachyarrhythmias (ATAs) are reportedly associated with ventricular arrhythmias (VAs). However, little is known about the association between ATA duration and the risk of VA. We investigated the relationship between ATA duration and subsequent VA in patients with a cardiac resynchronization therapy defibrillator (CRT-D). METHODS AND RESULTS: We investigated associations between the longest ATA duration during the first year after cardiac resynchronization therapy (CRT) implantation and VA and VA relevant to ATA (VAATA) in 160 CRT-D patients. ATAs occurred in 63 patients in the first year. During a median follow-up of 925 days from 1 year after CRT implantation, 40 patients experienced 483 VAs. Kaplan-Meier analysis showed a significantly higher risk of VA in patients with than without ATA in the first year (log rank P=0.0057). Hazard ratios (HR) of VA (HR 2.36, 2.10, and 3.04 for ATA >30s, >6 min and >24 h, respectively) and only VAATA (HR 4.50, 5.59, and 11.79 for ATA >30s, >6 min and >24 h, respectively) increased according to the duration of ATA. In multivariate analysis, ATA >24 h was an independent predictor of subsequent VA (HR 2.42; P=0.02). CONCLUSIONS: Patients with ATA >24 h in the first year after CRT had a higher risk of subsequent VA and VAATA. The risk of VA, including VAATA, increased with the longest ATA duration.
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Ueda et al. (2023) conducted a cohort in Congestive heart failure with CRT-D (n=160). Atrial tachyarrhythmia (ATA) duration >24 hours vs. No ATA or ATA ≤24 hours was evaluated on Subsequent ventricular arrhythmia (VA) (HR 2.42, 95% CI 1.16-5.07, p=0.02). An atrial tachyarrhythmia duration of >24 hours in the first year after cardiac resynchronization therapy defibrillator implantation independently predicted subsequent ventricular arrhythmias (HR 2.42).
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