S-164
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The evolution from standard
single chamber ICDs towards a fully integrated dual chamber system: clinical advantages
and limits
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Stefano Favale, Arnaldo Barletta,
Paolo Rizzon.
Dipartimento di Cardiologia, Universita di Bari, Italy
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Abstract
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Atrial sensing may further decrease ICD inappropriate
intervention incidence, albeit it is questionable if this favorable feature could offset
the more complex dual lead system; however, the advantage of atrial sensing may be
obtained by atrio-ventricular single lead technology avoiding the additional lead. This
may also be the solution for cases with A-V block and normal sinus node function. Dual
chamber ICD is suitable for patients who present at implantation time pacing indications
or if the addition of drugs, such as beta-blockers or amiodarone, which may determine
chronotropic incompetence, at rest and during exercise, may be predicted. The purpose of
DDD pacing for heart failure patients is to give sufficient chronotropic competence, an
optimal A-V sequential timing and a greater electrical stability. To date the prophylactic
use of dual chamber ICD in heart failure patients without pacing indications is still
questionable.
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Key Words
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Implantable cardioverter defibrillator – new
perspectives
dual chamber ICD, atrial sensing-pacing, arrhythmias detection algorithms, ICD
inappropriate incidences, R
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