Relationship between atrial tachyarrhythmias and symptoms
Section snippets
Study design
The study utilized a multicenter, randomized, single-blind parallel study design. Patient inclusion criteria included an American College of Cardiology/American Heart Association (ACC/AHA) class I or II indication for dual-chamber pacing,2 a history of atrial fibrillation within the past year, and no more than one cardioversion in the prior year. Patients with permanent or persistent atrial fibrillation, an indication for an implantable defibrillator, New York Heart Association (NYHA) class III
Patient characteristics
Table 1 summarizes patient demographic data, which were similar between patients randomized to the prevention and termination algorithms programmed either on or off. Among the 48 patients enrolled in the study, 45 completed the study. The data from these 45 patients are used for the analyses. Two patients died during the study.
The median device-stored atrial tachyarrhythmia burden was similar between patients randomized to have the prevention and termination algorithms programmed on or off (
Major findings
The major finding of this study is that in patients with symptomatic bradycardia, a history of atrial fibrillation, and an indication for permanent pacing, symptoms perceived to be related to atrial fibrillation often are not associated with an atrial tachyarrhythmia. In this study, almost 95% of documented atrial tachyarrhythmia episodes were asymptomatic, and symptoms attributed to atrial fibrillation were associated with atrial tachyarrhythmias only approximately 15% of the time.
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This study was supported in part by a research grant from Medtronic, Inc., Minneapolis, Minnesota. Paul D. Ziegler is an employee of Medtronic. Dr. Bahnson is a co-investigator for Medtronic. Dr. Strickberger receives research grants and unrestricted gifts, consults for, and occasionally is a paid speaker for Medtronic. Dr. Saksena receives consulting fees, royalties, and other remuneration from Medtronic.