The Symptoms and Clinical events associated with Automatic Reprogramming (SCARE) at replacement notification study

Research output: Contribution to journalArticle

Abstract

Background: Pacemaker patients experience battery depletion that activates pacemaker's alert for replacement notification. Automatic reprogramming at replacement notification can result in loss of rate response and atrioventricular (AV) synchrony. Objective: To determine if relevant symptoms or clinical events may be associated with automatic reprogramming at replacement notification. Methods: Electronic medical record review was undertaken for 298 patients referred for pacemaker generator replacement. Primary endpoints were symptoms or clinical events during replacement notification period. Results: Following elimination of duplicate pacemaker replacements (n = 12), “near-replacement notification” or “recalled” (n = 15) and pacemakers at “end of life” (n = 5), 266 subjects were included. Three distinct reprogramming cohorts were identified; those with no change (control) in pacing mode (n = 46), those with loss of rate response (n = 154), and those with loss of AV synchrony ± rate response (n = 66). In total, 83 subjects (31.2%) had symptoms with significant differences seen between groups (control = 4.3%, loss of rate response = 26.0%, loss of AV synchrony ± rate response = 62.1%, P < 0.001). Overall, 28 subjects (10.5%) experienced clinical events with significant differences seen between groups (control = 0.0%, loss of rate response = 6.5%, loss of AV synchrony ± rate response = 27.3%, P < 0.001). Conclusions: Automatic reprogramming at replacement notification was associated with significant symptoms in 26% of those who lost rate response and in 62% of those who lost AV synchrony ± rate response. Additionally, 27% of the latter cohort required nonelective clinical care.

Original languageEnglish (US)
JournalPACE - Pacing and Clinical Electrophysiology
DOIs
StateAccepted/In press - Jan 1 2018

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Control Groups
Electronic Health Records

Keywords

  • elective replacement indication
  • elective replacement time
  • pacemaker
  • pacemaker mode
  • pacemaker programming
  • recommended replacement time

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{62a399fa84f148abbb7453763bd5bcae,
title = "The Symptoms and Clinical events associated with Automatic Reprogramming (SCARE) at replacement notification study",
abstract = "Background: Pacemaker patients experience battery depletion that activates pacemaker's alert for replacement notification. Automatic reprogramming at replacement notification can result in loss of rate response and atrioventricular (AV) synchrony. Objective: To determine if relevant symptoms or clinical events may be associated with automatic reprogramming at replacement notification. Methods: Electronic medical record review was undertaken for 298 patients referred for pacemaker generator replacement. Primary endpoints were symptoms or clinical events during replacement notification period. Results: Following elimination of duplicate pacemaker replacements (n = 12), “near-replacement notification” or “recalled” (n = 15) and pacemakers at “end of life” (n = 5), 266 subjects were included. Three distinct reprogramming cohorts were identified; those with no change (control) in pacing mode (n = 46), those with loss of rate response (n = 154), and those with loss of AV synchrony ± rate response (n = 66). In total, 83 subjects (31.2{\%}) had symptoms with significant differences seen between groups (control = 4.3{\%}, loss of rate response = 26.0{\%}, loss of AV synchrony ± rate response = 62.1{\%}, P < 0.001). Overall, 28 subjects (10.5{\%}) experienced clinical events with significant differences seen between groups (control = 0.0{\%}, loss of rate response = 6.5{\%}, loss of AV synchrony ± rate response = 27.3{\%}, P < 0.001). Conclusions: Automatic reprogramming at replacement notification was associated with significant symptoms in 26{\%} of those who lost rate response and in 62{\%} of those who lost AV synchrony ± rate response. Additionally, 27{\%} of the latter cohort required nonelective clinical care.",
keywords = "elective replacement indication, elective replacement time, pacemaker, pacemaker mode, pacemaker programming, recommended replacement time",
author = "Sunil Sinha and Daniel Carlson and Jonathan Chrispin and Andreas Barth and Rickard, {John Jack} and Spragg, {David D} and Berger, {Ronald D} and Charles Love and Hugh Calkins and Tomaselli, {Gordon F.} and Joseph Marine",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/pace.13532",
language = "English (US)",
journal = "PACE - Pacing and Clinical Electrophysiology",
issn = "0147-8389",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - The Symptoms and Clinical events associated with Automatic Reprogramming (SCARE) at replacement notification study

AU - Sinha, Sunil

AU - Carlson, Daniel

AU - Chrispin, Jonathan

AU - Barth, Andreas

AU - Rickard, John Jack

AU - Spragg, David D

AU - Berger, Ronald D

AU - Love, Charles

AU - Calkins, Hugh

AU - Tomaselli, Gordon F.

AU - Marine, Joseph

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Pacemaker patients experience battery depletion that activates pacemaker's alert for replacement notification. Automatic reprogramming at replacement notification can result in loss of rate response and atrioventricular (AV) synchrony. Objective: To determine if relevant symptoms or clinical events may be associated with automatic reprogramming at replacement notification. Methods: Electronic medical record review was undertaken for 298 patients referred for pacemaker generator replacement. Primary endpoints were symptoms or clinical events during replacement notification period. Results: Following elimination of duplicate pacemaker replacements (n = 12), “near-replacement notification” or “recalled” (n = 15) and pacemakers at “end of life” (n = 5), 266 subjects were included. Three distinct reprogramming cohorts were identified; those with no change (control) in pacing mode (n = 46), those with loss of rate response (n = 154), and those with loss of AV synchrony ± rate response (n = 66). In total, 83 subjects (31.2%) had symptoms with significant differences seen between groups (control = 4.3%, loss of rate response = 26.0%, loss of AV synchrony ± rate response = 62.1%, P < 0.001). Overall, 28 subjects (10.5%) experienced clinical events with significant differences seen between groups (control = 0.0%, loss of rate response = 6.5%, loss of AV synchrony ± rate response = 27.3%, P < 0.001). Conclusions: Automatic reprogramming at replacement notification was associated with significant symptoms in 26% of those who lost rate response and in 62% of those who lost AV synchrony ± rate response. Additionally, 27% of the latter cohort required nonelective clinical care.

AB - Background: Pacemaker patients experience battery depletion that activates pacemaker's alert for replacement notification. Automatic reprogramming at replacement notification can result in loss of rate response and atrioventricular (AV) synchrony. Objective: To determine if relevant symptoms or clinical events may be associated with automatic reprogramming at replacement notification. Methods: Electronic medical record review was undertaken for 298 patients referred for pacemaker generator replacement. Primary endpoints were symptoms or clinical events during replacement notification period. Results: Following elimination of duplicate pacemaker replacements (n = 12), “near-replacement notification” or “recalled” (n = 15) and pacemakers at “end of life” (n = 5), 266 subjects were included. Three distinct reprogramming cohorts were identified; those with no change (control) in pacing mode (n = 46), those with loss of rate response (n = 154), and those with loss of AV synchrony ± rate response (n = 66). In total, 83 subjects (31.2%) had symptoms with significant differences seen between groups (control = 4.3%, loss of rate response = 26.0%, loss of AV synchrony ± rate response = 62.1%, P < 0.001). Overall, 28 subjects (10.5%) experienced clinical events with significant differences seen between groups (control = 0.0%, loss of rate response = 6.5%, loss of AV synchrony ± rate response = 27.3%, P < 0.001). Conclusions: Automatic reprogramming at replacement notification was associated with significant symptoms in 26% of those who lost rate response and in 62% of those who lost AV synchrony ± rate response. Additionally, 27% of the latter cohort required nonelective clinical care.

KW - elective replacement indication

KW - elective replacement time

KW - pacemaker

KW - pacemaker mode

KW - pacemaker programming

KW - recommended replacement time

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U2 - 10.1111/pace.13532

DO - 10.1111/pace.13532

M3 - Article

C2 - 30375674

AN - SCOPUS:85056342288

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JF - PACE - Pacing and Clinical Electrophysiology

SN - 0147-8389

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