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Initial Clinical Experience with a Dual Chamber Rate Responsive Implantable Cardioverter Defibrillator
Author(s) -
LUCERI RICHARD M.
Publication year - 2000
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2000.tb07068.x
Subject(s) - medicine , defibrillation , bradycardia , cardiology , implantable cardioverter defibrillator , defibrillation threshold , sinus bradycardia , implant , ejection fraction , heart rate , surgery , heart failure , blood pressure
The present study reports the first clinical experience with the Photon DR dual chamber rate responsive ICD. Fifty‐seven patients (mean age 67.6 ± 10 years) with a mean LVEF of 0.332 in NYHA Class I (30%), II (51%), or III (19%) met the implant criteria. Tachyarrhythmia diagnoses included VF (21%), VT (49%), or VT/VF (30%). Additional bradycardia pacing diagnoses included AV block (18%), sinus node dysfunction (5%), and sinus bradycardia (11%). All patients were followed on a long‐term basis. A device‐based direct current fibrillator (DC fibber) successfully induced VF in 96.2% of 243 attempted inductions. Detection times (2.86 ± 0.47 s) and redetection times (1.29 ± 0.32 s) compared favorably with historic controls using a morphology detection (MD) clinical data. Defibrillation energy and voltage thresholds were 10.4 ± 5.5 J (range 3–28) and 421 V ± 108 (range 230–696), respectively. Ninety‐two clinical arrhythmias were recorded. Using a nominal nonindividualized algorithm, the sensitivity for VT detection was 100% and specificity for SVT rejection 81%. There were six patient deaths (2 nonsudden arrhythmic, 2 cardiac, 2 other). In conclusion, early clinical experience with the Photon DR ICD supports its safety, efficacy, and ability to provide advanced dual chamber ICD features.