Prevention of inappropriate therapies and serious adverse cardiac and cerebrovascular events with a single chamber implantable defibrillator with DX floating dipole atrial detection
Prospective, randomized, open-label, multicenter, international study in a population with an accepted indication for an implantable automatic defibrillator. The main objective is to know the different values of the rates of inappropriate therapies, of serious cardiac and cerebrovascular adverse events, and of the appropriate detections in single-chamber ICD devices, with optimized programming according to the patient's arrhythmic history, using the three discrimination methods. arrhythmias: Smart, Onset and Stability, and Morphmatch. The device under investigation is a single chamber with a floating atrial dipole for the detection of atrial signals. Patients who are included in the study will present an indication for an automatic cardioverter-defibrillator device according to clinical practice guidelines for an ICD and who also do not have an indication for permanent stimulation in the right atrium. For this reason, the indication of patients will be those that require an ICD without the implantation of an electrode in the atrium, that is, single-chamber ICDs or DX ICDs since both, from the therapeutic point of view, are equivalent. The centers will follow standard clinical practice to diagnose patients
Study Type
OBSERVATIONAL
Enrollment
462
DAI for the detection of atrial signals with optimized programming, using Smart, Onset \& Stability, and Morphmatch methods
Hospital Universitario Clínico de Santiago
Santiago de Compostela, A Coruña, Spain
ACTIVE_NOT_RECRUITINGHospital Universitario de Araba
The combined rate of inappropriate therapies and serious adverse cardiac and cerebrovascular events (MACCE) single-chamber devices with floating atrial dipole with the Smart function activated
determine the combined rate is not less than in single-chamber devices without atrial detection using any of the supraventricular arrhythmia discrimination modalities: Onset and Stability, and Morphmatch.
Time frame: 24 months
Inappropriate therapies distribution
According to the type of indication for an ICD in primary and secondary prevention
Time frame: 24 months
Programming adjustment justification
Adjustments suggested by the European Heart Rhythm Association
Time frame: 24 months
Distribution of inappropriate therapies by chosen schedule
Time frame: 24 months
Proportion of appropriate and inappropriate diagnoses
By diagnosis group
Time frame: 24 months
Differences in events according to Onset & Stability method versus Morphmatch method
Events in single chamber programming without floating dipole
Time frame: 24 months
Appropriate therapies by group and by indication
Portion of appropriate therapies
Time frame: 24 months
Triggers of Inappropriate therapies
Time frame: 24 months
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Vitoria-Gasteiz, Alava, Spain
Hospital Universitario Germans Trias i Pujol
Badalona, Barcelona, Spain
RECRUITINGHospital Universitario de Bellvitge
L'Hospitalet de Llobregat, Barcelona, Spain
RECRUITINGHospital Universitario de Donostia
Donostia / San Sebastian, Guipúzcoa, Spain
RECRUITINGHospital Universitario Puerta de Hierro
Majadahonda, Madrid, Spain
RECRUITINGHospital Álvaro Cunqueiro
Vigo, Pontevedra, Spain
RECRUITINGComplejo Hospitalario Universitario de Canarias
Santa Cruz de Tenerife, Tenerife, Spain
ACTIVE_NOT_RECRUITINGComplejo Hospitalario Universitario A Coruña
A Coruña, Spain
RECRUITINGHospital Universitario Josep Trueta
Girona, Spain
RECRUITING...and 6 more locations
Patients presenting atrial fibrillation before inclusion
percentage
Time frame: 24 months
Patients with no prior history of atrial fibrillation (AF) who have AF during study follow-up
Percentage
Time frame: 24 months
General atrial load in patients with and without previous manifestation of atrial fibrillation
Time frame: 24 months
Percentage of patients with clinical AF (atrial fibrillation) versus subclinical AF (<6 minutes duration).
Clinical AF meaning \> 6 minutes duration and subclinical AF meaning \<6 minutes duration
Time frame: 24 months
Cerebrovascular events presenting previous episodes of atrial fibrillation
Rate
Time frame: 24 months