What is the clinical evidence from this study?

Study design: Observational. Population: Patients with a single-lead VDD-ICD (n=106). Intervention: Ventricular far-field sensing in a single-lead VDD-ICD. Primary outcome: Atrial near- and ventricular far-field sensing and its impact on the dual-chamber detection algorithm.

What question did this study set out to answer?

To assess atrial near-field and ventricular far-field sensing and determine their clinical impact on dual-chamber arrhythmia detection algorithms in patients with a single-lead VDD-ICD.

March 1, 2007Pacing and Clinical Electrophysiology

Incidence and Significance of Far‐Field R Wave Sensing in a VDD‐Implantable Cardioverter Defibrillator

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Key result

Ventricular far-field sensing in a single-lead VDD-ICD was common (46% >0.35 mV) but only misclassified 4.5% of sinus tachycardia episodes as ventricular tachycardia.

Why the study?

Does ventricular far-field sensing impair tachycardia detection in patients with a single-lead VDD-ICD?

Population

106 patients with a single-lead VDD-ICD

Design

Cohort

Follow-up

12-month

Authors

FEFrank EberhardtBond University ASAndreas SchuchertFriedrich-Ebert-Krankenhaus DSDietmar SchmitzGerman Center for Neurodegenerative Diseases

Discussion

Member takes

Implication

Reassures on low misclassification risk with VDD-ICDs; leaves open need for randomized confirmation in varied rhythms.

Key Points

To assess atrial near-field and ventricular far-field sensing and determine their clinical impact on dual-chamber arrhythmia detection algorithms in patients with a single-lead VDD-ICD.
Monitored 106 patients implanted with a single-lead VDD-ICD across a 12-month follow-up period encompassing 639 follow-up evaluations.
Analyzed signal amplitudes and classified 645 spontaneous tachycardia episodes to identify inappropriate therapies or detection delays caused by far-field sensing.
Mean near-field amplitude was 3.82 ± 1.76 mV and mean far-field amplitude was 0.31 ± 0.15 mV, with 46% of patients exhibiting far-field amplitudes >0.35 mV and 35% showing corresponding atrial electrogram markers.
Far-field sensing led to 3 of 66 sinus tachycardia episodes (4.5%) being misclassified as ventricular tachycardia resulting in inappropriate therapy, while delayed detection occurred in 12 of 323 ventricular tachycardia episodes (3.7%) across 5 of 62 patients (delay 6.4 ± 6.0 seconds).
Stable far-field amplitudes <0.2 mV showed a high negative predictive value for device malfunction, whereas higher amplitudes had only moderate correlation with detection errors.

Study Design

Type

Observational (n=106)

Structured PICO

Does ventricular far-field sensing impair tachycardia detection in patients with a single-lead VDD-ICD?

Population

106 patients with a single-lead VDD-ICD evaluated for atrial near- and ventricular far-field sensing over a 12-month follow-up period.

Exposure

Single-lead VDD-ICD

Outcome

Atrial near- and ventricular far-field sensing and its impact on the dual-chamber detection algorithm over a 12-month follow-up periodsurrogate

Ventricular far-field sensing is common in single-lead VDD-ICDs but does not severely compromise the dual-chamber tachycardia detection algorithm.

Cite This Study

Eberhardt et al. (2007) conducted an observational in Patients with a single-lead VDD-ICD (n=106). Ventricular far-field sensing in a single-lead VDD-ICD was evaluated on Atrial near- and ventricular far-field sensing and its impact on the dual-chamber detection algorithm. Ventricular far-field sensing in a single-lead VDD-ICD was common (46% >0.35 mV) but only misclassified 4.5% of sinus tachycardia episodes as ventricular tachycardia.

synapsesocial.com/papers/6a845e1b7b4d6f59a47c09eb https://doi.org/10.1111/j.1540-8159.2007.00681.x

Topics

Ventricular arrhythmias

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Incidence and Significance of Far‐Field R Wave Sensing in a VDD‐Implantable Cardioverter Defibrillator

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Incidence and Significance of Far‐Field R Wave Sensing in a VDD‐Implantable Cardioverter Defibrillator

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider