TY - JOUR
T1 - The Symptoms and Clinical events associated with Automatic Reprogramming (SCARE) at replacement notification study
AU - Sinha, Sunil K.
AU - Carlson, Daniel
AU - Chrispin, Jonathan
AU - Barth, Andreas S.
AU - Rickard, John Jack
AU - Spragg, David D.
AU - Berger, Ronald
AU - Love, Charles
AU - Calkins, Hugh
AU - Tomaselli, Gordon F.
AU - Marine, Joseph E.
N1 - Publisher Copyright:
© 2018 Wiley Periodicals, Inc.
PY - 2018/12
Y1 - 2018/12
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
UR - http://www.scopus.com/inward/record.url?scp=85056342288&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056342288&partnerID=8YFLogxK
U2 - 10.1111/pace.13532
DO - 10.1111/pace.13532
M3 - Article
C2 - 30375674
AN - SCOPUS:85056342288
SN - 0147-8389
VL - 41
SP - 1611
EP - 1618
JO - PACE - Pacing and Clinical Electrophysiology
JF - PACE - Pacing and Clinical Electrophysiology
IS - 12
ER -