Clinical investigationsEffect of an implantable cardioverter defibrillator with atrial detection and shock therapies on patient-perceived, health-related quality of life☆
Section snippets
Device
After review and approval by each participating institution’s local ethics review committee, a Medtronic model 7250 dual-chamber ICD was evaluated in 267 patients from 45 centers (Europe, United States, and Canada). This is a multiprogrammable device capable of DDD pacing while detecting and treating episodes of either atrial or ventricular tachyarrhythmias. The device is able to store information on both treated and untreated detected arrhythmias. The device discriminates atrial tachycardias
Results
Most patients in the study group were male (73%), and the mean patient age was 62 ± 12 years. Eighty-seven patients (32%) had a history of coronary artery disease, and 52 patients (19%) had a prior myocardial infarction. Patient characteristics, including ejection fraction and NYHA classification, are presented in Table I. In the 12 months before implantation, patients experienced a mean ± SD of 11.3 ± 20 episodes of AF and 2.0 ± 8.9 episodes of atrial flutter.
Of the 267 patients who underwent
Discussion
This is the first study to demonstrate that implantation of a dual-chamber ICD with atrial pacing and defibrillation therapies is associated with an improvement in patient-perceived, health-related QOL. The overall magnitude of this improvement ranged from 0.11 to 0.63 SD units. The benefit of improved QOL persisted across NYHA classes (I and II vs III), shock delivery (1-4 shocks vs ≥5 shocks), and mode of shock delivery (patient-activated shock therapy vs automatic shocks). The observed
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Supported in part by grants from Medtronic, Minneapolis, Minn.