Reduced Atrial Tachyarrhythmia Susceptibility After Upgrade of Conventional Implanted Pulse Generator to Cardiac Resynchronization Therapy in Patients With Heart Failure
Demetris Yannopoulos, MD*,
Keith G. Lurie, MD, FACC*, ,
Scott Sakaguchi, MD, FACC, FHRS*,,
Simon Milstein, MD, FACC,,
Cengiz Ermis, MD*,
Laura VanHeel, RN and
David G. Benditt, MD, FACC, FRCPC, FHRS*,,*
* Cardiac Arrhythmia Center, Department of Medicine (Cardiovascular Division), University of Minnesota Medical School, the University of Minnesota Medical Center–Fairview, Minneapolis, Minnesota
Central Minnesota Heart Center, St. Cloud Hospital, St. Cloud, Minnesota
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Figure 1 Intracardiac Electrogram of Atrial Fibrillation
Intracardiac atrial and ventricular electrograms during atrial tachyarrhythmia episodes from one patient before cardiac resynchronization therapy. Atrio-atrial (A-A) and ventriculo-ventricular (V-V) intervals are indicated.
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Figure 2 Percentage of Patients Free From Atrial Tachycardia Over the Course of the Study
Graph illustrating the percentage of patients without atrial tachyarrhythmia over the course of the study (1 year before and 2 years after cardiac resynchronization therapy [CRT]). *Statistically significant difference, p < 0.01.
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Figure 3 Atrial Tachycardia Characteristics
Bar graphs depicting mean ± SD of frequency (atrial tachycardia episodes/year), maximum atrial tachycardia duration in minutes, and maximum atrial rate recorded by the implanted device (in most cases equal to the mode switch rate) before and after the upgrade to cardiac resynchronization therapy. *Statistically significant difference, p < 0.05.
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Figure 4 Frequency of AT Episodes/Month
Bar graphs illustrating mean ± SD of the number of atrial tachycardia (AT) episodes in 1 month recorded at 12 months before cardiac resynchronization therapy (CRT), 3 months before CRT, and 3 and 12 months after upgrade to CRT. *Statistically significant difference, p < 0.05.
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Figure 5 Effect of CRT Upgrade on Hospital Stays
(A) Bar graphs summarizing the number of hospital stays in 1 year before and after the upgrade to cardiac resynchronization therapy (CRT). Findings show diminished number of atrial tachyarrhythmia (AT) and heart failure (HF) hospital stays after CRT, whereas other hospital stays (see text) were unaffected. *Statistically significant difference in the number of hospital stays before and after CRT (p < 0.05). (B and C) Distribution (number of patients) of the number of hospital stays/year/patient (total and AT-related) before and after CRT upgrade. p values = 0.001 and <0.001, respectively.
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