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July 22, 2019Journal of Cardiovascular ElectrophysiologyOpen Access

AHRE detection rate was significantly higher in the DX cohort (13%) compared to the single-chamber cohort (5.3%, P = .026), but not significantly different from the dual-chamber cohort (13%).

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Why the study?

Subclinical AF detected as AHREs by cardiac implantable devices is associated with thromboembolism, but whether a single-lead ICD with a floating atrial dipole could effectively detect AHREs was unclear.

Does a single lead ICD system with a floating atrial sensing dipole improve subclinical atrial fibrillation detection compared to conventional single-chamber ICD systems in patients without prior AF?

Comparison

DX ICD vs matched single-chamber and dual-chamber ICD cohorts

Design

Prospective multicenter cohort-controlled trial

Follow-up

Median 12 months

Authors

GTGeorge ThomasDCDaniel ChoiHDHarish Doppalapudi

Discussion

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Overview

DX ICDs may enhance subclinical AF detection versus single-chamber devices in ICD recipients; leaves open need for randomized outcome trials.

Structured PICO

Does a single lead ICD system with a floating atrial sensing dipole improve subclinical atrial fibrillation detection compared to conventional single-chamber ICD systems in patients without prior AF?

P
Population
150 patients without prior history of atrial fibrillation, mean age 59 ± 13 years, 72% male.
I
Intervention
Single lead (DX) implantable cardioverter-defibrillator (ICD) system with a floating atrial sensing dipole
C
Comparator
Age-, sex-, and left ventricular ejection fraction-matched single- and dual-chamber ICD cohorts derived from a Cornell database and the IMPACT trial
O
Outcome
Atrial high rate episode (AHRE) detection at 12 monthssurrogate

A single-lead ICD system with a floating atrial dipole provides superior subclinical atrial fibrillation detection compared to conventional single-chamber ICDs, performing similarly to dual-chamber systems.

Cite This Study

Thomas et al. (2019) studied this question.

synapsesocial.com/papers/6a716394c2d7c30908270cd0https://doi.org/10.1111/jce.14081
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The role of atrial sensing for new‐onset atrial arrhythmias diagnosis and management in single‐chamber implantable cardioverter‐defibrillator recipients: Results from the THINGS registry2020 · 24 citations
  2. 2Ability to remotely monitor atrial high-rate episodes using a single-chamber implantable cardioverter-defibrillator with a floating atrial sensing dipole2023 · 13 citations
  3. 3New‐Onset Device‐Detected Atrial Fibrillation in Patients With Atrial Floating Dipole Implantable Cardioverter‐Defibrillators: A Propensity Score‐Matched Comparison With Conventional Dual‐Chamber Systems2025 · 1 citations
  4. 4The utilization of atrial sensing dipole in single lead implantable cardioverter defibrillator for detection of new‐onset atrial high‐rate episodes or subclinical atrial fibrillation: A systematic review and meta‐analysis2022 · 5 citations
  5. 5REACT DX registry: Real world REACTion to atrial high rate episodes detected in implantable cardioverter-defibrillator recipients with a DX lead2022 · 2 citations