Dr. George Thomas, Principal Investigator of the SENSE Study, on DX Technology and AHRE Detection.
Dr. Chris Liu of Weill Cornell Medical College, New York, NY, on Dual-Lead Equivalency and Single-Lead Simplicity with DX Technology.
Dr. George Thomas, Principal Investigator of the SENSE Study, on Inappropriate Therapies for Ventricular Arrythmias with DX Technology.
DX Technology is Superior to Single-Chamber and Comparable with Dual-Chamber in Detecting Atrial High-Rate Episodes (AHRE) …
The SENSE study showed that the AHRE detection rate6 was significantly higher in the DX cohort compared to the single-chamber cohort (p=0.026).7 While AHRE detection was not significantly different from the dual-chamber cohort (p=1.00),8 multivariate regression showed that the use of DX was associated with AHRE detection.9
![SENSE study](/sites/default/files/styles/site_width/public/2020-12/SENSE%20study%2C%20AHRE%20detection%20percentage%2C%20bar%20chart%2C%20EN.png?itok=iGripOQ3)
![Time to first AHRE detection Time to first AHRE detection](/sites/default/files/2020-12/Time%20to%20first%20AHRE%20detection.png)
… and Shows Stable and Reliable Atrial Sensing
![SENSE study, Mean sensed atrial amplitude at implant, DX cohort,](/sites/default/files/styles/site_width/public/2020-12/SENSE%20study%2C%20Mean%20sensed%20atrial%20amplitude%20at%20implant%2C%20DX%20cohort%2C%20Icon%2C%208.0%20mV_1.png?itok=M4ghP4kl)
Mean sensed atrial amplitude
at implant10
![SENSE study, Mean sensed atrial amplitude at 12-month follow-up, DX cohort](/sites/default/files/styles/site_width/public/2020-12/SENSE%20study%2C%20Mean%20sensed%20atrial%20amplitude%20at%2012-month%20follow-up%2C%20DX%20cohort%2C%20Icon%2C%207.3%20mV_0.png?itok=NyNPqdqi)
Mean sensed atrial amplitude
at 12-month follow-up11
![THINGS study, Appropriate atrial signal detection at 2-year follow-up, ICD DX group](/sites/default/files/styles/site_width/public/2020-12/THINGS%20study%2C%20Appropriate%20atrial%20signal%20detection%20at%202-year%20follow-up%2C%20ICD%20DX%20group%2C%20Icon%2C%2098.6%20%25_2.png?itok=Xp7OoMS8)
Additional results from the THINGS registry showed that almost all patients had appropriate atrial signal detection at 2-year follow-up.12
The Incidence of AT/AF Diagnosis is Significantly Higher with DX Technology Compared to Single-Chamber ICDs ...
Results from the THINGS registry also show that DX systems are associated with an almost 4-fold likelihood of detecting AT/AF compared to conventional devices.13
![THINGS study, New-Onset AT+AF Diagnosis, Diagram, THINGS study, New-Onset AT+AF Diagnosis, Diagram,](/sites/default/files/2020-12/THINGS%20study%2C%20New-Onset%20AT%2BAF%20Diagnosis%2C%20Diagram%2C%20EN.png)
![2year incidence DX Technology - 2year incidence](/sites/default/files/2020-12/2year_incidence2.png)
…Leading to a Trend of Increased Onset of Oral Anticoagulation.14
![THINGS study, Oral Anticoagulation Onset THINGS study, Oral Anticoagulation Onset](/sites/default/files/2020-12/THINGS%20study%2C%20Oral%20Anticoagulation%20Onset%2C%20Diagram%2C%20Diagram%2C%20EN.png)
CRT-DX Extends the Advantages of DX Technology also to Cardiac Resynchronization Therapy, Allowing for a Significantly Lower Rate of Major Complications…
The QP ExCELs registry has shown that with CRT-DX, there were significantly fewer patients who experienced major complications.15
![QP ExCELs study, Freedom from primary endpoint major complications QP ExCELs study, Freedom from primary endpoint major complications](/sites/default/files/2020-12/QP%20ExCELs%20study%2C%20Freedom%20from%20primary%20endpoint%20major%20complications%2C%20Diagram%2C%20EN.png)
…While Achieving Similar CRT Responses in LV Pacing and Clinical Outcome Parameters.
There were no significant differences in median LV pacing between groups.16
![QP ExCELs study, Median LV pacing during CRT, CRT-DX group QP ExCELs study, Median LV pacing during CRT, CRT-DX group](/sites/default/files/2020-12/QP%20ExCELs%20study%2C%20Median%20LV%20pacing%20during%20CRT%2C%20CRT-DX%20group%2C%20Icon%2C%2098.4%20%25%20vs.%2098.9%25_2.png)
Clinical outcomes in the two groups were similar.17
All values represent percentage of patients.
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1 Safak E et al. Clinical efficacy and safety of an implantable cardioverter-defibrillator lead with a floating atrial sensing dipole. Pacing Clin Electrophysiol. 2013; 36: 952-62.
2 Iori M et al. Implantable cardioverter defibrillator system with floating atrial sensing dipole: a single-center experience. Pacing Clin Electrophysiol. 2014; 37(10):1265-73.
3 Sinha et al. Discrimination of VT and SVTs with a new detection algorithm in a dual-chamber ICD. Herzschrittmacher. 2000; 20(3): 208-14.
4 Thomas G et al. Subclinical atrial fibrillation detection with a floating atrial sensing dipole in single lead implantable cardioverter‐defibrillator systems: Results of the SENSE trial. J Cardiovasc Electrophysiol. 2019; 30: 1994‐ 2001.
5 Biffi M et al. Less is more: Can we achieve cardiac resynchronization with 2 leads only? Int J Cardiol. 2017; 249:184-190.
6 AHREs were defined as atrial tachyarrhythmias with atrial rate greater than 200 bpm lasting for > 30 seconds.
7-11 Thomas G et al. Subclinical atrial fibrillation detection with a floating atrial sensing dipole in single lead implantable cardioverter‐defibrillator systems: Results of the SENSE trial. J Cardiovasc Electrophysiol. 2019; 30: 1994‐ 2001. 1
9 adjusted HR 2.40; 1.05-5.48; p = 0.038
10-11 Mean sensed atrial amplitude was 8.0 ± 5.0 mV at implant and 7.3 ± 4.8 mV at 12-month follow-up.
12 Biffi M- et al. The role of atrial sensing for new-onset atrial arrhythmias diagnosis and management in single-chamber implantable cardioverter-defibrillator recipients: Results from the THINGS registry. J Cardiovasc Electrophysiol. 2020; 31: 846– 853.
14 Biffi M et al. The role of atrial sensing for new-onset atrial arrhythmias diagnosis and management in single-chamber implantable cardioverter-defibrillator recipients: Results from the THINGS registry. J Cardiovasc Electrophysiol. 2020; 31: 846– 853.
15-17 Shaik, NA et al. Novel two‐lead cardiac resynchronization therapy system provides equivalent CRT responses with less complications than a conventional three‐lead system: Results from the QP ExCELs lead registry. J Cardiovasc Electrophysiol. 2020; 31: 1784– 1792.2