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Cardiac Implantable Electronic Devices in the Short Stay Management of Atrial Fibrillation

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Short Stay Management of Atrial Fibrillation

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

The use of implantable cardiac devices continues to increase in atrial fibrillation patients. The potential roles for these devices can include defibrillation, pacing, resynchronization, and physiologic monitoring. While referral for implantable devices generally occurs in the outpatient setting, an acute care encounter may provide an opportunity for recognition of a patient with an appropriate indication for a device. Therefore, we briefly discuss the indications for an implantable cardiac device in atrial fibrillation patients, so as to facilitate recognition and potential referral. We will also discuss the data elements that can potentially be obtained from cardiac devices, as well as how this data can potentially aid in the diagnosis and treatment of acute atrial fibrillation.

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References

  1. Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics-2015 update: a report from the american heart association. Circulation. 2015;131:e29–322.

    Article  PubMed  Google Scholar 

  2. Bernstein AD, Daubert JC, Fletcher RD, et al. The revised NASPE/BPEG generic code for antibradycardia, adaptive-rate, and multisite pacing. North American Society of Pacing and Electrophysiology/British Pacing and Electrophysiology Group. Pacing Clin Electrophysiol. 2002;25:260–4.

    Article  PubMed  Google Scholar 

  3. Brignole M, Auricchio A, Baron-Esquivias G, et al. 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Europace. 2013;15:1070–118.

    Article  PubMed  Google Scholar 

  4. Chatterjee NA, Upadhyay GA, Ellenbogen KA, McAlister FA, Choudhry NK, Singh JP. Atrioventricular nodal ablation in atrial fibrillation: a meta-analysis and systematic review. Circ Arrhythm Electrophysiol. 2012;5:68–76.

    Article  PubMed  Google Scholar 

  5. Patel D, Daoud EG. Atrioventricular junction ablation for atrial fibrillation. Cardiol Clin. 2014;32:573–83.

    Article  PubMed  Google Scholar 

  6. Curtis AB, Kutalek SP, Prior M, Newhouse TT. Prevalence and characteristics of escape rhythms after radiofrequency ablation of the atrioventricular junction: results from the registry for AV junction ablation and pacing in atrial fibrillation. Ablate and Pace Trial Investigators. Am Heart J. 2000;139:122–5.

    Article  CAS  PubMed  Google Scholar 

  7. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64:e1–76.

    Article  PubMed  Google Scholar 

  8. Carlson MD, Ip J, Messenger J, et al. A new pacemaker algorithm for the treatment of atrial fibrillation: results of the Atrial Dynamic Overdrive Pacing Trial (ADOPT). J Am Coll Cardiol. 2003;42:627–33.

    Article  PubMed  Google Scholar 

  9. Gillis AM, Morck M, Exner DV, et al. Impact of atrial antitachycardia pacing and atrial pace prevention therapies on atrial fibrillation burden over long-term follow-up. Europace. 2009;11:1041–7.

    Article  PubMed  Google Scholar 

  10. Hohnloser SH, Healey JS, Gold MR, et al. Atrial overdrive pacing to prevent atrial fibrillation: insights from ASSERT. Heart Rhythm. 2012;9:1667–73.

    Article  PubMed  Google Scholar 

  11. Kantharia BK, Freedman RA, Hoekenga D, et al. Increased base rate of atrial pacing for prevention of atrial fibrillation after implantation of a dual-chamber pacemaker: insights from the atrial overdrive pacing study. Europace. 2007;9:1024–30.

    Article  PubMed  Google Scholar 

  12. Mont L, Ruiz-Granell R, Martinez JG, et al. Impact of anti-tachycardia pacing on atrial fibrillation burden when added on top of preventive pacing algorithms: results of the prevention or termination (POT) trial. Europace. 2008;10:28–34.

    Article  PubMed  Google Scholar 

  13. Veasey RA, Arya A, Silberbauer J, et al. The relationship between right ventricular pacing and atrial fibrillation burden and disease progression in patients with paroxysmal atrial fibrillation: the long-MinVPACE study. Europace. 2011;13:815–20.

    Article  PubMed  Google Scholar 

  14. Jhanjee R, Templeton GA, Sattiraju S, et al. Relationship of paroxysmal atrial tachyarrhythmias to volume overload: assessment by implanted transpulmonary impedance monitoring. Circ Arrhythm Electrophysiol. 2009;2:488–94.

    Article  PubMed  Google Scholar 

  15. Nattel S, Harada M. Atrial remodeling and atrial fibrillation: recent advances and translational perspectives. J Am Coll Cardiol. 2014;63:2335–45.

    Article  PubMed  Google Scholar 

  16. Zhu P, Zhang Y, Jiang P, et al. Effects of radiofrequency catheter ablation on left ventricular structure and function in patients with atrial fibrillation: a meta-analysis. J Interv Card Electrophysiol. 2014;40:137–45.

    Article  PubMed  Google Scholar 

  17. Zipes DP, Camm AJ, Borggrefe M, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for practice guidelines (writing committee to develop guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114:e385–484.

    Article  PubMed  Google Scholar 

  18. Myerburg RJ. Sudden cardiac death: exploring the limits of our knowledge. J Cardiovasc Electrophysiol. 2001;12:369–81.

    Article  CAS  PubMed  Google Scholar 

  19. Group M-HS. Effect of metoprolol CR/XL in chronic heart failure: metoprolol CR/XL randomised intervention trial in congestive heart failure (MERIT-HF). Lancet. 1999;353:2001–7.

    Article  Google Scholar 

  20. Epstein AE, DiMarco JP, Ellenbogen KA, et al. ACC/AHA/HRS 2008 Guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (writing committee to revise the ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation. 2008;117:e350–408.

    Article  PubMed  Google Scholar 

  21. Moss AJ, Hall WJ, Cannom DS, et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. N Engl J Med. 1996;335:1933–40.

    Article  CAS  PubMed  Google Scholar 

  22. Moss AJ, Zareba W, Hall WJ, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346:877–83.

    Article  PubMed  Google Scholar 

  23. Bardy GH, Lee KL, Mark DB, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med. 2005;352:225–37.

    Article  CAS  PubMed  Google Scholar 

  24. Solomon SD, Foster E, Bourgoun M, et al. Effect of cardiac resynchronization therapy on reverse remodeling and relation to outcome: multicenter automatic defibrillator implantation trial: cardiac resynchronization therapy. Circulation. 2010;122:985–92.

    Article  PubMed  Google Scholar 

  25. Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. 2002;346:1845–53.

    Article  PubMed  Google Scholar 

  26. Bristow MR, Saxon LA, Boehmer J, et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004;350:2140–50.

    Article  CAS  PubMed  Google Scholar 

  27. Cleland JG, Daubert JC, Erdmann E, et al. Longer-term effects of cardiac resynchronization therapy on mortality in heart failure [the CArdiac REsynchronization-Heart Failure (CARE-HF) trial extension phase]. Eur Heart J. 2006;27:1928–32.

    Article  PubMed  Google Scholar 

  28. Cleland JG, Daubert JC, Erdmann E, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005;352:1539–49.

    Article  CAS  PubMed  Google Scholar 

  29. Linde C, Abraham WT, Gold MR, et al. Randomized trial of cardiac resynchronization in mildly symptomatic heart failure patients and in asymptomatic patients with left ventricular dysfunction and previous heart failure symptoms. J Am Coll Cardiol. 2008;52:1834–43.

    Article  PubMed  Google Scholar 

  30. Moss AJ, Hall WJ, Cannom DS, et al. Cardiac-resynchronization therapy for the prevention of heart-failure events. N Engl J Med. 2009;361:1329–38.

    Article  PubMed  Google Scholar 

  31. Rickard J, Bassiouny M, Tedford RJ, et al. Long-term outcomes in patients with ambulatory New York Heart Association class III and IV heart failure undergoing cardiac resynchronization therapy. Am J Cardiol. 2015;115:82–5.

    Article  PubMed  Google Scholar 

  32. Young JB, Abraham WT, Smith AL, et al. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD trial. JAMA. 2003;289:2685–94.

    Article  PubMed  Google Scholar 

  33. Ruschitzka F, Abraham WT, Singh JP, et al. Cardiac-resynchronization therapy in heart failure with a narrow QRS complex. N Engl J Med. 2013;369:1395–405.

    Article  CAS  PubMed  Google Scholar 

  34. Lopes C, Pereira T, Barra S. Cardiac resynchronization therapy in patients with atrial fibrillation: a meta-analysis. Rev Port Cardiol. 2014;33:717–25.

    PubMed  Google Scholar 

  35. Yin J, Hu H, Wang Y, et al. Effects of atrioventricular nodal ablation on permanent atrial fibrillation patients with cardiac resynchronization therapy: a systematic review and meta-analysis. Clin Cardiol. 2014;37:707–15.

    Article  PubMed  Google Scholar 

  36. Gasparini M, Leclercq C, Lunati M, et al. Cardiac resynchronization therapy in patients with atrial fibrillation: the CERTIFY study (cardiac resynchronization therapy in atrial fibrillation patients multinational registry). JACC Heart Fail. 2013;1:500–7.

    Article  PubMed  Google Scholar 

  37. Martindale J, DeSouza S. Managing pacemaker-related complications and malfunctions in the emergency department. Emerg Med Pract. 2014;16:1–21; quiz -2.

    PubMed  Google Scholar 

  38. Neuenschwander JF, Hiestand BC, Peacock WF, et al. A pilot study of implantable cardiac device interrogation by emergency department personnel. Crit Pathw Cardiol. 2014;13:6–8.

    Article  PubMed  Google Scholar 

  39. Korkeila P, Nyman K, Ylitalo A, et al. Venous obstruction after pacemaker implantation. Pacing Clin Electrophysiol. 2007;30:199–206.

    Article  PubMed  Google Scholar 

  40. Da Costa SS, Scalabrini Neto A, Costa R, Caldas JG, Martinelli Filho M. Incidence and risk factors of upper extremity deep vein lesions after permanent transvenous pacemaker implant: a 6-month follow-up prospective study. Pacing Clin Electrophysiol. 2002;25:1301–6.

    Article  PubMed  Google Scholar 

  41. van Rooden CJ, Molhoek SG, Rosendaal FR, Schalij MJ, Meinders AE, Huisman MV. Incidence and risk factors of early venous thrombosis associated with permanent pacemaker leads. J Cardiovasc Electrophysiol. 2004;15:1258–62.

    Article  PubMed  Google Scholar 

  42. Pavia S, Wilkoff B. The management of surgical complications of pacemaker and implantable cardioverter-defibrillators. Curr Opin Cardiol. 2001;16:66–71.

    Article  CAS  PubMed  Google Scholar 

  43. Sandoe JA, Barlow G, Chambers JB, et al. Guidelines for the diagnosis, prevention and management of implantable cardiac electronic device infection. Report of a joint working party project on behalf of the British Society for Antimicrobial Chemotherapy (BSAC, host organization), British Heart Rhythm Society (BHRS), British Cardiovascular Society (BCS), British Heart Valve Society (BHVS) and British Society for Echocardiography (BSE). J Antimicrob Chemother. 2015;70:325–59.

    Article  CAS  PubMed  Google Scholar 

  44. Wang TJ, Larson MG, Levy D, et al. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham heart study. Circulation. 2003;107:2920–5.

    Article  PubMed  Google Scholar 

  45. Caldwell JC, Contractor H, Petkar S, et al. Atrial fibrillation is under-recognized in chronic heart failure: insights from a heart failure cohort treated with cardiac resynchronization therapy. Europace. 2009;11:1295–300.

    Article  PubMed  Google Scholar 

  46. Ip JE, Cheung JW, Park D, et al. Temporal associations between thoracic volume overload and malignant ventricular arrhythmias: a study of intrathoracic impedance. J Cardiovasc Electrophysiol. 2011;22:293–9.

    Article  PubMed  Google Scholar 

  47. Moore HJ, Peters MN, Franz MR, Karasik PE, Singh SN, Fletcher RD. Intrathoracic impedance preceding ventricular tachyarrhythmia episodes. Pacing Clin Electrophysiol. 2010;33:960–6.

    PubMed  Google Scholar 

  48. Perego GB, Landolina M, Vergara G, et al. Implantable CRT device diagnostics identify patients with increased risk for heart failure hospitalization. J Interv Card Electrophysiol. 2008;23:235–42.

    Article  PubMed  Google Scholar 

  49. Goldsmith RL, Bigger JT, Bloomfield DM, et al. Long-term carvedilol therapy increases parasympathetic nervous system activity in chronic congestive heart failure. Am J Cardiol. 1997;80:1101–4.

    Article  CAS  PubMed  Google Scholar 

  50. Adamson PB, Kleckner KJ, VanHout WL, Srinivasan S, Abraham WT. Cardiac resynchronization therapy improves heart rate variability in patients with symptomatic heart failure. Circulation. 2003;108:266–9.

    Article  PubMed  Google Scholar 

  51. Adamson PB, Smith AL, Abraham WT, et al. Continuous autonomic assessment in patients with symptomatic heart failure: prognostic value of heart rate variability measured by an implanted cardiac resynchronization device. Circulation. 2004;110:2389–94.

    Article  PubMed  Google Scholar 

  52. Yamada A, Hayano J, Sakata S, et al. Reduced ventricular response irregularity is associated with increased mortality in patients with chronic atrial fibrillation. Circulation. 2000;102:300–6.

    Article  CAS  PubMed  Google Scholar 

  53. Ahmad S, Tejuja A, Newman KD, Zarychanski R, Seely AJ. Clinical review: a review and analysis of heart rate variability and the diagnosis and prognosis of infection. Crit Care. 2009;13:232.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Camillo CA, Pitta F, Possani HV, et al. Heart rate variability and disease characteristics in patients with COPD. Lung. 2008;186:393–401.

    Article  PubMed  Google Scholar 

  55. Whellan DJ, Ousdigian KT, Al-Khatib SM, et al. Combined heart failure device diagnostics identify patients at higher risk of subsequent heart failure hospitalizations: results from PARTNERS HF (program to access and review trending information and evaluate correlation to symptoms in patients with heart failure) study. J Am Coll Cardiol. 2010;55:1803–10.

    Article  PubMed  Google Scholar 

  56. Yu CM, Wang L, Chau E, et al. Intrathoracic impedance monitoring in patients with heart failure: correlation with fluid status and feasibility of early warning preceding hospitalization. Circulation. 2005;112:841–8.

    Article  PubMed  Google Scholar 

  57. Abraham WT, Compton S, Haas G, et al. Intrathoracic impedance vs daily weight monitoring for predicting worsening heart failure events: results of the Fluid Accumulation Status Trial (FAST). Congest Heart Fail. 2011;17:51–5.

    Article  PubMed  Google Scholar 

  58. Catanzariti D, Lunati M, Landolina M, et al. Monitoring intrathoracic impedance with an implantable defibrillator reduces hospitalizations in patients with heart failure. Pacing Clin Electrophysiol. 2009;32:363–70.

    Article  PubMed  Google Scholar 

  59. Vanderheyden M, Houben R, Verstreken S, et al. Continuous monitoring of intrathoracic impedance and right ventricular pressures in patients with heart failure. Circ Heart Fail. 2010;3:370–7.

    Article  PubMed  Google Scholar 

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Correspondence to Brian Hiestand MD, MPH .

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Hiestand, B., Wong, A. (2016). Cardiac Implantable Electronic Devices in the Short Stay Management of Atrial Fibrillation. In: Peacock, W., Clark, C. (eds) Short Stay Management of Atrial Fibrillation. Contemporary Cardiology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-31386-3_13

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  • DOI: https://doi.org/10.1007/978-3-319-31386-3_13

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