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December 15, 2010Circulation Arrhythmia and ElectrophysiologyOpen Access

A+-ICD reduces implant time by 12 minutes vs standard DR-ICD with equivalent tachyarrhythmia detection.

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Why the study?

Does a single-lead atrial sensing A+-ICD system reduce implantation time and maintain equivalent rhythm discrimination compared to a conventional dual-chamber ICD in patients without antibradycardia pacing indications?

Population

249 patients with standard implantable cardioverter-defibrillator indications but no requirement for…

Comparison

A+-ICD system vs Conventional dual-chamber (DR)-ICD

Design

RCT, randomized

Follow-up

12 months

Key result

The novel A+-ICD system was implanted significantly faster than a standard DR-ICD (67 vs 79 minutes, P=0.003) and showed equivalent detection of tachyarrhythmias.

Authors

CSChristian SticherlingMZMarkus ZabelSSSebastian Spencker

Discussion

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Overview

A+-ICD may shorten implantation with equivalent SVT/VT discrimination; leaves open whether it reduces revisions versus dual-chamber systems.

Study Design

Type

RCT (n=249)

Randomization

randomized

Structured PICO

Does a single-lead atrial sensing A+-ICD system reduce implantation time and maintain equivalent rhythm discrimination compared to a conventional dual-chamber ICD in patients without antibradycardia pacing indications?

P
Population
249 patients with standard ICD indications but no requirement for antibradycardia pacing, followed for 12 months.
I
Intervention
A+-ICD system (single-lead atrial sensing system with integrated atrial sensing rings mounted 15 to 18 cm from the tip of an ICD lead)
C
Comparator
Conventional dual-chamber (DR)-ICD
O
Outcome
Implantation details (time), need for ICD system revision, long-term sensing, documented arrhythmia episodes, and rhythm discrimination at 12 months follow-up

Main Result

Absolute Event Rate: 67% vs 79%

p-value: p=0.003

The novel single-lead A+-ICD system reduces implantation time while providing equivalent atrial sensing and arrhythmia discrimination compared to standard dual-chamber ICDs.

Cite This Study

Sticherling et al. (2010) conducted an RCT in Standard ICD indications without antibradycardia pacing requirement (n=249). A+-ICD system vs. DR-ICD system was evaluated on Implantation time (p=0.003). The novel A+-ICD system was implanted significantly faster than a standard DR-ICD (67 vs 79 minutes, P=0.003) and showed equivalent detection of tachyarrhythmias.

synapsesocial.com/papers/6aa72aa8eb8aab1a4ee08e10https://doi.org/10.1161/circep.110.958397
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Also Consider

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

  1. 1First worldwide clinical experience with a new dual chamber implantable cardioverter defibrillator. Advantages and complications1999 · 24 citations
  2. 2Chronic Experiences with a Single Lead Dual Chamber Implantable Cardioverter Defibrillator System2003 · 16 citations
  3. 3Avoiding inappropriate therapy of single‐lead implantable cardioverter‐defibrillator by using atrial‐sensing electrodes2018 · 19 citations
  4. 4Clinical Experience with Tiered Atrial Therapies and Atrial Arrhythmia Prevention Algorithms in a Dual Chamber Cardioverter Defibrillator2006 · 5 citations
  5. 5The 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