Overview of Pacemakers and Implantable Cardioverter Defibrillators
Single chamber icd implant
the risk of inappropriate therapy increases with lower detection rates programmed in the icd. complication rates associated with pacemaker or implantable cardioverter-defibrillator generator replacements and upgrade procedures results from the replace registry. and acronymsacc, american college of cardiology; aha, american heart association; av-icd, atrioventricular (dual-chamber) implantable cardioverter-defibrillator; avid, anti-arrhythmics versus implantable defibrillators trial; chf, congestive heart failure; david, dual-chamber and vvi implantable defibrillator trial; eps, electrophysiology/electrophysiologic study; icd, implantable cardioverter-defibrillator; madit, multicenter automatic defibrillator implantation trial; mustt, multicenter unsustained tachycardia trial; naspe, north american society of pacing and electrophysiology; scd-heft, sudden cardiac death in heart failure trialthe implantable cardioverter-defibrillator (icd) is the standard of care for patients at risk for sudden cardiac death (1, 2, 3 and 4). cost for a single-chamber icd is less than an atrioventricular (dual-chamber) icd (av-icd); however, some patients without clinical need for av-icd at implantation might require a later upgrade, potentially offsetting the initial cost advantage of the single-chamber device. overall, the number of implanted dual-chamber devices has been increasing and, according to the 2003 aiac registry data, accounted for one-third of all the defibrillators implanted in italy, while single chamber devices made up 39%./3750pmcid: pmc3399500a new single chamber implantable defibrillator with atrial sensing: a practical demonstration of sensing and ease of implantationdietmar bänsch, ralph schneider, ibrahim akin, and cristoph a.
Battle of Dual- Versus Single-Chamber ICDs | Medpage Today
therefore, it is the primary -- and hopefully most frequent -- task of the icd to give you confidence that your heart is not beating too rapidly or too slowly on its own accord. pa, mcclelland rl, bamlet wr et al (2006) dual-chamber versus single-chamber detection enhancements for implantable defibrillator rhythm diagnosis: the detect supraventricular tachycardia study. 6 despite the advantages of a dual chamber icd for diagnosis and differentiation of tachycardias, the concept of implanting it merely for the sake of detection is generally not accepted, because the improved detection is counter-balanced by the increased risk of lead complications, as well as increased mortality and morbidity. springer, milanoabstractpatients in whom an implantable cardioverter defibrillator (icd) is indicated and who have concomitant significant sinus-node disease or atrioventricular block may be candidates for a dual-chamber device. however, the danger of inappropriate therapies is high, particularly in single-chamber devices. this paper depicts the placement of this electrode, in order to highlight the data from the master study and to demonstrate both the ease of implantation and the excellent sensing capabilities of this electrode.
Implantable cardioverter-defibrillator - Wikipedia
Our ICD Systems - Tachyarrhythmia Management | Medtronic
a transthoracic echo was performed prior to implantation in order to re-evaluate left ventricular ejection fraction and to exclude a ventricular thrombus, which might prohibit defibrillator testing during implantation. here, the ease of implantation of the system will be demonstrated. t, jung w, wolpert c et al (1998) a new classification algorithm for discrimination of ventricular from supraventricular tachycardia in a dual chamber implantable cardioverter defibrillator. designwe developed a decision analytic model to estimate the economic costs of three alternative implantation strategies in icd recipients who do not demonstrate the need for a dual-chamber device at time of implant: 1) initial implantation of a single-chamber device in all patients with later upgrade to an av-icd as clinically needed; 2) initial implantation of an av-icd in all patients; and 3) targeted initial device selection on the basis of the results of electrophysiologic testing. r, aronow ws, sorbera c et al (2005) left ventricular ejection fraction and prevalence of new left ventricular wall motion abnormality at long-term follow-up in patients with automatic implantable cardioverter-defibrillators treated with dual-chamber rate-responsive pacing at a rate of 70/minute versus backup ventricular pacing at a rate of 40/minute. the icd monitors your heartbeat and delivers electrical pulses when necessary.
A New Single Chamber Implantable Defibrillator with Atrial Sensing
sensitivity analyses demonstrated that universal av-icd implantation remained least expensive with upgrade rates as low as 10%. the decision was made to implant a single-chamber icd with atrial detection capability in order to monitor further episodes of atrial fibrillation and to avoid inappropriate therapy in an otherwise very active patient. dual-chamber implantable cardioverter-defibrillator selection is associated with increased complication rates and mortality among patients enrolled in the ncdr implantable cardioverter-defibrillator registry. in this trial, patients with slow vt were implanted with a dual-chamber icd that was either programmed to dual- or single- chamber detection. diagnosis, assessment, and plan the treatment plan was to implant a lumax vr-t dx defibrillator with a biotronik linoxsmart s dx lead under regional anesthesia in the electrophysiological laboratory. gr, pina il, kutalek sp (1991) intrinsic conduction maximizes cardiopulmonary performance in patients with dual chamber pacemakers.
How To Choose Between Single-Chamber and Dual-Chamber ICD
the sensing facilities are similar to a dual chamber devices and the complication rate is as low as in conventional single chamber icds.: medicine, issue 60, implantable defibrillator, dual chamber, single chamber, tachycardia detectiondownload video file., who randomly assigned patients to dch- or sch icd implantation. implantable cardioverter defibrillator (icd) - this device can save your life! however, it is still a matter of debate whether the dual-chamber icd is also advantageous for patients with preserved sinus and atrioventricular nodal function, as data from prospective randomized trials are limited. real world evaluation of dual-zone icd and crt-d programming compared to single-zone programming.
w, flores bf, marchlinski fe (1992) electrocardiographically documented unnecessary, spontaneous shocks in 241 patients with implantable cardioverter defibrillators. to determine which of these three strategies for device selection in patients requiring icd therapy would be least costly, we constructed a decision-analysis model with retrospective data from our institution on device usage. implantation procedure peri-procedural preparation included a single intravenous dose of prophylactic antibiotic and subcutaneous heparin. i, kolb c, ndrepepa g et al (2001 do current dual chamber cardioverter defibrillators have advantages over conventional single chamber cardioverter defibrillator in reducing inappropriate therapies? david paltiel, phd†, rachel lampert, md⁎, , (facc)⁎ school of medicine, yale university, new haven, connecticut† school of epidemiology and public health, yale university, new haven, connecticutreceived 25 june 2004, revised 29 april 2005, accepted 17 may 2005, available online 16 august 2005objectivesthe purpose of this study was to determine the least expensive strategy for device selection in patients receiving implantable cardioverter-defibrillators (icds). j, deseo t, gerber ae, bertel o (1996) a comparison of quality-of-life in patients with dual chamber pacemakers and individually programmed atrioventricular delays.
Association of Single vs. Dual Chamber ICDs with Mortality
however, their trial did not particularly address patients with slow vts as the mean tachycardia detection interval was 368 ms, and concluded that single- and dual-chamber devices are equally effective for therapy in life-threatening ventricular tachyarrhythmias. comparison of a novel, single-lead atrial sensing system with a dual-chamber implantable cardioverter-defibrillator system in patients without antibradycardia pacing indications results of a randomized study. introduction implantable cardioverter-defibrillators (icd) prevent sudden cardiac death (scd) in patients after survived scd or at risk of scd due to impaired left ventricular function. the linoxsmart s dx electrode combined with the lumax dx icd offers this advantage. even when your heart is beating a little too slowly, rapidly or irregularly, the icd will sense this and, in most cases, be able to prevent worse from happening by delivering weak electrical impulses, which most patients don't even notice. the excellent signal quality can only be achieved by a special filter setting in the icd (lumax 540 and 740 vr-t dx, biotronik).
icd, implantable cardioverter defibrillator - world's single chamber
analysis was used to estimate expected resource utilization costs of three alternative implantation strategies: 1) single-chamber device in all, with later upgrade to av-icd if needed; 2) initial implantation of an av-icd in all; and 3) targeted device selection on the basis of results of electrophysiologic testing (presence or absence of induced bradyarrhythmias or atrial arrhythmias). bl, cook jr, epstein ae et al (2002) the david trial investigators: dual chamber pacing or ventricular backup pacing in patients with an implantable defibrillator. overall, the implantation was successful and the patient was discharged from the hospital the following day. c, deisenhofer i, schmieder s et al (2006) long-term follow-up of patients supplied with single-chamber or dual-chamber cardioverter defibrillators. & implantable defibrillators: how are they implanted and what is their function? f, schwarzacher s, eibl g, pachinger o (2001) inappropriate detection of supraventricular arrhythmias by implantable dual chamber defibrillators: a comparison of four different algorithms.
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researchcost advantage of dual-chamber versus single-chamber cardioverter-defibrillator implantationzachary goldberger, md⁎, brian elbel, mph†, craig a. for this endpoint, the 1+1-trial demonstrated the significant superiority of dual-chamber (dch) detection with a long tachycardia detection interval (tdi) compared with conventionally programmed single-chamber (sch) detection. of icd recipients, 15% to 20% require antibradycardia pacing, owing to intrinsic sinus node dysfunction or conduction system disease, or use of medications with negative chronotropic properties (7 and 8). 239-243how to choose between single-chamber and dual-chamber icdauthorsauthors and affiliationsmaurizio del grecolorena gramegnamassimiliano marinimarcello disertoriconference paperdoi:10. patients without other indications for electrophysiologic study (eps), the expected per-person cost was least with the strategy of universal initial av-icd implantation (,232) compared with initial single-chamber icd/upgrade as needed (,230) or eps-guided selection (,130). one manufacturer, biotronik, developed a ventricular single chamber electrode with atrial sensing capabilities.