Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Oct;4(4-5):135-138.
doi: 10.4021/cr292w. Epub 2013 Oct 15.

Predictors of Recurrent Atrial Fibrillation Using Mode Switch Quantification

Phillip Ruisi  1 , John N Makaryus  2 , John N Catanzaro  3 , Michael Ruisi  4 , Anthony Cedrone  2 , Amgad N Makaryus  2 , Erik Altman  2 , Ram Jadonath  2 , Stuart Beldner  2
Affiliations

Predictors of Recurrent Atrial Fibrillation Using Mode Switch Quantification

Phillip Ruisi et al. Cardiol Res. 2013 Oct.

Abstract

Background: The efficacy of mode switching to predict atrial fibrillation has been established in the literature. There have been few studies investigating the incidence and clinical implication of mode switch episodes quantified from implantable cardioverter defibrillator and pacemaker interrogation. We sought to investigate the incidence of mode switch recurrence in patients with implantable cardioverter defibrillators and permanent pacemakers.

Methods: Mode switch was defined as any occurrence documented during device interrogation after the date of implantation. Clinical predictors (age, gender, hypertension, diabetes, syncope, atrial fibrillation (AF)), and medications were analyzed to determine association with single and recurrent mode switch occurrences.

Results: There were 21 patients experiencing a mode switch event, identified from a group of 54 patients (42 males; mean age 70 ± 12 years; mean follow-up 29.1 ± 22 months (3.4 - 81.4 months)). All but two patients were receiving medical therapy including beta blockers, statins, ace-inhibitors, and anti-arrhythmics. There were 21 subjects who experienced at least one mode switch during their follow-up and 33 subjects who never experienced a mode switch during their follow-up time. The median time to first mode switch from device implantation was 39.3 months. Risk factors individually associated with any mode switch episode included: diabetes (DM) (P < 0.04) and use of digitalis (P = 0.02). Subjects who had a history of DM were 5 times more likely to have at least one mode switch occurrence. There was a significantly higher rate of mode switch among patients who were diabetic than patients who were not (3.7 per follow-up month ± 5.3 vs. 0.98 per follow-up month ± 2.02; P = 0.02). There was a significantly higher rate of mode switch among patients who were on digitalis than those who were not (3.1 per follow-up month ± 4.3 vs. 0.73 per follow-up month ± 1.9; P = 0.02).

Conclusion: The main factors associated with any mode switch are having a history of diabetes and digitalis use. Those patients who are diabetics and those on digitalis may warrant closer observation and management for the development of atrial fibrillation.

Keywords: Atrial fibrillation; Cardioverter defibrillator; Mode switch; Permanent pacemaker.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Israel CW. [Mode-switching algorithms: programming and usefulness] Herz. 2001;26(1):2–17. doi: 10.1007/PL00002003. - DOI - PubMed
    1. Bernstein AD, Daubert JC, Fletcher RD, Hayes DL, Luderitz B, Reynolds DW, Schoenfeld MH. 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(2):260–264. doi: 10.1046/j.1460-9592.2002.00260.x. - DOI - PubMed
    1. Kamalvand K, Tan K, Kotsakis A, Bucknall C, Sulke N. Is mode switching beneficial? A randomized study in patients with paroxysmal atrial tachyarrhythmias. J Am Coll Cardiol. 1997;30(2):496–504. doi: 10.1016/S0735-1097(97)00162-9. - DOI - PubMed
    1. Chugh SS, Blackshear JL, Shen WK, Hammill SC, Gersh BJ. Epidemiology and natural history of atrial fibrillation: clinical implications. J Am Coll Cardiol. 2001;37(2):371–378. doi: 10.1016/S0735-1097(00)01107-4. - DOI - PubMed
    1. Heeringa J, van der Kuip DA, Hofman A, Kors JA, van Herpen G, Stricker BH, Stijnen T. et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J. 2006;27(8):949–953. doi: 10.1093/eurheartj/ehi825. doi: 10.1093/eurheartj/ehi825. - DOI - DOI - PubMed

LinkOut - more resources