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January 15, 2022Journal of ArrhythmiaOpen Access

VDD-ICD significantly increased the detection of new-onset AHREs or subclinical atrial fibrillation compared to VVI-/DDD-ICD (OR 2.6; 95% CI 1.2-5.8; p=0.018).

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Why the study?

To evaluate the performance of the atrial sensing dipole in single-lead ICD recipients for diagnosing new-onset AHREs or subclinical AF.

Does VDD-ICD improve the detection of new-onset AHREs or SCAF in ICD recipients compared to VVI-/DDD-ICD?

Population

991 participants across 3 prospective studies

Comparison

VDD-ICD vs contemporary single- and dual-chamber ICD (VVI-/DDD-ICD)

Design

Systematic review and meta-analysis of prospective studies

Follow-up

Median 365 days to 847 days

Key result

VDD-ICD significantly increased the detection of new-onset AHREs or subclinical atrial fibrillation compared to VVI-/DDD-ICD (OR 2.6; 95% CI 1.2-5.8; p=0.018).

Authors

XPXuanming PungDHDaniel Zhihao HongTHTzyy Yeou Ho

Discussion

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Overview

Supports VDD-ICD selection to enhance AHRE/SCAF detection in ICD recipients; confirms meta-analytic superiority over VVI-/DDD systems.

Study Design

Type

Meta-Analysis (n=991)

Structured PICO

Does VDD-ICD improve the detection of new-onset AHREs or SCAF in ICD recipients compared to VVI-/DDD-ICD?

P
Population
991 participants (78% men) from 3 prospective studies comparing VDD-ICD to VVI-/DDD-ICD, followed for a median of 365 to 847 days.
I
Intervention
Single lead implantable cardioverter defibrillator with atrial sensing dipole (VDD-ICD)
C
Comparator
Contemporary single-chamber (VVI-ICD) or dual-chamber (DDD-ICD) implantable cardioverter defibrillators
O
Outcome
Detection of new-onset atrial high-rate episodes (AHREs, rate threshold 200 bpm) or subclinical atrial fibrillation (SCAF, device-detected AF without symptoms)surrogate

Main Result

Odds Ratio: 2.6 (95% CI 1.2–5.8)

p-value: p=0.018

The use of a floating atrial sensing dipole in VDD-ICDs significantly increases the detection of new-onset AHREs or subclinical AF compared to VVI-ICDs, with performance similar to DDD-ICDs.

Cite This Study

Pung et al. (2022) conducted a meta-analysis in Implantable cardioverter defibrillator (ICD) recipients (n=991). VDD-ICD (single lead ICD with atrial sensing dipole) vs. VVI-/DDD-ICD was evaluated on Detection of new-onset atrial high-rate episodes (AHREs) or subclinical atrial fibrillation (SCAF) (OR 2.6, 95% CI 1.2, 5.8, p=0.018). VDD-ICD significantly increased the detection of new-onset AHREs or subclinical atrial fibrillation compared to VVI-/DDD-ICD (OR 2.6; 95% CI 1.2-5.8; p=0.018).

synapsesocial.com/papers/6a9878bae58ec8b8f024bff3https://doi.org/10.1002/joa3.12675
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Also Consider

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

  1. 1Arrhythmia Detection in Atrioventricular, Single-Lead, Floating Atrial Dipole ICD Systems Compared with Conventional Single- and Dual-Chamber Defibrillators2024 · 2 citations
  2. 2New‐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
  3. 3Subclinical atrial fibrillation detection with a floating atrial sensing dipole in single lead implantable cardioverter‐defibrillator systems: Results of the SENSE trial2019 · 34 citations
  4. 4The 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
  5. 5Chronic Experiences with a Single Lead Dual Chamber Implantable Cardioverter Defibrillator System2003 · 16 citations