scholarly journals Atrial signal amplitude predicts atrial high‐rate episodes in implantable cardioverter defibrillator patients: Insights from a large database of remote monitoring transmissions

2020 ◽  
Vol 36 (2) ◽  
pp. 353-362
Author(s):  
Massimo Zecchin ◽  
Francesco Solimene ◽  
Antonio D'Onofrio ◽  
Gabriele Zanotto ◽  
Saverio Iacopino ◽  
...  
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Remote Monitoring ◽  
Signal Amplitude ◽  
High Rate ◽  
Large Database ◽  
Cardioverter Defibrillator

scholarly journals Sacubitril/valsartan reduces atrial fibrillation and supraventricular arrhythmias in patients with HFrEF and remote monitoring: preliminary data from the SAVE THE RHYTHM

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Guerra ◽  
L Pimpini ◽  
M Flori ◽  
D Contadini ◽  
G Stronati ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Implantable Cardioverter Defibrillator ◽  
Remote Monitoring ◽  
Preliminary Data ◽  
Premature Ventricular Contractions ◽  
Cardioverter Defibrillator ◽  
Neprilysin Inhibitor ◽  
History Of ◽  
Secondary Endpoints ◽  
The Mean

Abstract Background Sacubitril/valsartan, the first combined angiotensin receptor-neprilysin inhibitor, has demonstrated a significant benefit compared to angiotensin inhibitor in decreasing ventricular arrhythmias and appropriate implantable cardioverter defibrillator (ICD) shocks in patients with heart failure with reduced ejection fraction (HFrEF). At present, there is no study which evaluates the effect of sacubitril/valsartan on the supraventricular arrhythmic burden in HFrEF patients with an ICD or cardiac resynchronisation therapy-defibrillator (CRT-D) and remote monitoring. Purpose To evaluate the effect of sacubitril/valsartan on the supraventricular arrhythmic burden in HFrEF patients with an ICD or CRTD and remote monitoring. Methods The SAVETHERHYTHM ((SAacubitril Valsartan rEal-world registry evaluating THE arRHYTHMia burden in HFrEF patients with implantable cardioverter defibrillator) is a multicentre, observational, prospective registry enrolling all patients with HFrEF, ICD or CRT-D actively followed through remote monitoring and starting treatment with sacubitril/valsartan. All patients are followed-up for at least one year after sacubitril/valsartan start. The primary endpoint is the mean number of sustained atrial tachycardia or atrial fibrillation (AT/AF) episodes per month. Secondary endpoints include the total burden of AT/AF (defined as the percentage of time in AT/AF per day), the mean number of premature ventricular contractions (PVC) per hour and the percentage of biventricular pacing per day (in patients with CRT-D). All primary and secondary endpoints are collected through remote monitoring. Results At the time of the first ad interim analysis, 60 patients (85.2% male, age 69±10 years) were consecutively enrolled. After treatment with sacubitril/valsartan, patients with at least one episode of AT/AF per month decreased from 32.8% to 21.3% (p=0.015). A significant decrease in number of AT/AF episodes (from 4.3 to 1.2 per year), in AT/AF burden (from 12% to 9%) and in number of PVC (from 83 to 74 per hour) were seen in patients with a previous diagnosis of paroxysmal or persistent AF (n=15; all p<0.05). Patients with permanent AF (n=7) experienced no benefits from sacubitril/valsartan therapy in terms of arrhythmic burden reduction. Patients with no previous history of AF (n=38) showed a decrease in number of AT/AF episodes (from 2.0 to 0.8 per year) and in number of PVC (from 77 to 49 per hour, all p<0.05). No new diagnosis of clinical AF was made after starting treatment with sacubitrl/valsartan, and patients with subclinical AT/AF episodes decreased from 8% to 3%. Conclusions Preliminary data suggest that therapy with sacubitril/valsartan could decrease arrhythmic burden in patients with non-permanent AF and reduce subclinical AT/AF episodes in patients with no history of AF. No positive effect has been noted in patients with permanent AF. Funding Acknowledgement Type of funding source: None

scholarly journals Efficacy and Safety of Automatic Remote Monitoring for Implantable Cardioverter-Defibrillator Follow-Up

Circulation ◽  
2010 ◽  
Vol 122 (4) ◽  
pp. 325-332 ◽  
Author(s):  
Niraj Varma ◽  
Andrew E. Epstein ◽  
Anand Irimpen ◽  
Robert Schweikert ◽  
Charles Love
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Remote Monitoring ◽  
Efficacy And Safety ◽  
Cardioverter Defibrillator

scholarly journals Long‐Term Outcomes Among a Nationwide Cohort of Patients Using an Implantable Cardioverter‐Defibrillator: UMBRELLA Study Final Results

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sem Briongos‐Figuero ◽  
Arcadio García‐Alberola ◽  
Jerónimo Rubio ◽  
José María Segura ◽  
Aníbal Rodríguez ◽  
...  
Keyword(s):  
Heart Disease ◽  
Dilated Cardiomyopathy ◽  
Implantable Cardioverter Defibrillator ◽  
Valvular Heart Disease ◽  
Lower Risk ◽  
Ischemic Cardiomyopathy ◽  
High Rate ◽  
Icd Therapy ◽  
Cardioverter Defibrillator

Background Large‐scale studies describing modern populations using an implantable cardioverter‐defibrillator (ICD) are lacking. We aimed to analyze the incidence of arrhythmia, device interventions, and mortality in a broad spectrum of real‐world ICD patients with different heart disorders. Methods and Results The UMBRELLA study is a prospective, multicenter, nationwide study of contemporary patients using an ICD followed up by remote monitoring, with a blinded review of arrhythmic episodes. From November 2005 to November 2017, 4296 patients were followed up. After 46.6±27.3 months, 16 067 episodes of sustained ventricular arrhythmia occurred in 1344 patients (31.3%). Appropriate ICD therapy occurred in 27.3% of study population. Patients with ischemic cardiomyopathy (hazard ratio [HR], 1.51; 95% CI, 1.29–1.78), dilated cardiomyopathy (HR, 1.28; 95% CI, 1.07–1.53), and valvular heart disease (HR, 1.94; 95% CI, 1.43–2.62) exhibited a higher risk of appropriate ICD therapies, whereas patients with hypertrophic cardiomyopathy (HR, 0.72; 95% CI, 0.54–0.96) and Brugada syndrome (HR, 0.25; 95% CI, 0.14–0.45) showed a lower risk. All‐cause death was 13.4% at follow‐up. Ischemic cardiomyopathy (HR, 3.09; 95% CI, 2.58–5.90), dilated cardiomyopathy (HR, 3.33; 95% CI, 2.18–5.10), and valvular heart disease (HR, 3.97; 95% CI, 2.25–6.99) had the worst prognoses. Delayed high‐rate detection was enabled in 39.7% of patients, and single‐zone programming occurred in 52.6% of primary prevention patients. Both parameters correlated with lower risk of first appropriate ICD therapy, with no excess risk of mortality. The rate of inappropriate shocks at follow‐up was low (6%) and did not differ among type of ICD but was lower in SmartShock‐capable devices. Conclusions Irrespective of the cause, contemporary ICD patients with heart failure–related disorders had a similar risk of ICD life‐saving interventions and death. Current ICD programming recommendations still need to be implemented. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NTC01561144.

Work burden with remote monitoring of implantable cardioverter defibrillator

2013 ◽  
Vol 14 (2) ◽  
pp. 114-119 ◽  
Author(s):  
Lida P. Papavasileiou ◽  
Giovanni B. Forleo ◽  
Germana Panattoni ◽  
Valentina Schirripa ◽  
Valentina Minni ◽  
...  
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Remote Monitoring ◽  
Cardioverter Defibrillator ◽  
Work Burden
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