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- W2083507913 abstract "The complex relationship between heart failure (HF) and cardiac arrhythmias, including both atrial (AT) and ventricular (VT) tachycardia, is not well understood. We examined the temporal association between changes in intrathoracic impedance, suggesting thoracic fluid accumulation, and both AT and VT using a device database of de-identified data from CRT-D and ICD patients. A retrospective analysis was conducted on device data stored in the Medtronic (Minneapolis, MN) Discovery Link database to identify patients with HF based upon intrathoracic impedance derived fluid index (OptiVol) threshold crossings (FTC). Identifiable patient information was removed to protect privacy. Trends in these values 60 days before and after a FTC were examined by plotting daily means calculated for data from all patients. A total of 46,696 patients (68±12 yr, 52% ICD, 75% male), with a FTC occurring at least 94 days post-implant (mean 263 ± 146 days) were evaluated. Patients had a mean of 4±3 FTC over the entire 22.8±10.3 month follow up period. Mean population AT burden, defined as mean device detected net duration of AT per day, and the proportion of patients with a VT episode both rose significantly (p<0.001) in the days immediately prior to FTC threshold crossing. This relation was even more robust, when analysis was confined to the 10.4% of patients with device classified AT >1hr on at least one day, and averaging <23, hours per day. Heart rate variability, an index of autonomic function, also decreased significantly prior to FTC (figure). Population AT burden and VT frequency increase significantly immediately prior to intrathoracic impedance fluid index threshold crossings in ICD and CRT-D subjects. Remotely monitored device diagnostic data may be used to identify subsets of patients in whom the temporal relationship between HF and arrhythmias might influence clinical treatment plans." @default.
- W2083507913 created "2016-06-24" @default.
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- W2083507913 date "2011-08-01" @default.
- W2083507913 modified "2023-09-26" @default.
- W2083507913 title "Temporal Association between Fluid Accumulation and Atrial and Ventricular Tachyarrhythmias: An Analysis of 46,696 CRT-D and ICD Patients" @default.
- W2083507913 doi "https://doi.org/10.1016/j.cardfail.2011.06.171" @default.
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