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Morning peak in ventricular tachyarrhythmias detected by time of implantable cardioverter/defibrillator therapy
Background A morning peak in occurrence of sudden cardiac death has been identified in epidemiological studies, but the studies are subject to selection bias, with the exclusion of unwitnessed deaths, which are more likely to occur at night. The recent availability of implantable cardioverter/defibr...
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| Published in: | Circulation (New York, N.Y.) N.Y.), 1995-09, Vol.92 (5), p.1203-1208 |
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| Language: | English |
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| cited_by | cdi_FETCH-LOGICAL-c338t-cc136e6668903eace8f4a44f0986cf3cdc546c255c6f27a69b6d99b598fbb88a3 |
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| cites | cdi_FETCH-LOGICAL-c338t-cc136e6668903eace8f4a44f0986cf3cdc546c255c6f27a69b6d99b598fbb88a3 |
| container_end_page | 1208 |
| container_issue | 5 |
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| container_title | Circulation (New York, N.Y.) |
| container_volume | 92 |
| creator | TOFLER, G. H GEBARA, O. C. E MITTLEMAN, M. A TAYLOR, P SIEGEL, W VENDITTI, F. J RASMUSSEN, C. A MULLER, J. E |
| description | Background
A morning peak in occurrence of sudden cardiac death has been identified in epidemiological studies, but the studies are subject to selection bias, with the exclusion of unwitnessed deaths, which are more likely to occur at night. The recent availability of implantable cardioverter/defibrillators that record the time of ventricular tachyarrhythmias requiring either pacing or shock therapy provides an opportunity to clarify the timing of ventricular tachyarrhythmias predisposing to sudden cardiac death. Analysis of the timing of arrhythmias in different patient subgroups, such as patients with poor left ventricular function, may provide further insight into the mechanism of onset of sudden cardiac death.
Methods and Results
We studied patients in whom a cardioverter/defibrillator (Ventak PRx) was implanted between September 1990 and September 1993 in US centers. Events that could be timed occurred in 483 patients. With an RR cycle length of 240 ms as a cutoff, corresponding to a heart rate of 250 beats per minute, episodes were categorized as rapid (n=1217) or less rapid (n=9266) ventricular tachyarrhythmias. A higher proportion of both rapid and less rapid ventricular tachyarrhythmias began in the late morning compared with other times of the day. The subgroup of patients with ejection fraction |
| doi_str_mv | 10.1161/01.CIR.92.5.1203 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_212709938</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>23934389</sourcerecordid><originalsourceid>FETCH-LOGICAL-c338t-cc136e6668903eace8f4a44f0986cf3cdc546c255c6f27a69b6d99b598fbb88a3</originalsourceid><addsrcrecordid>eNo9kE1r3DAQhkVoods09x5F6dWOPiytdCxLmwZSCqU5i7E86ir12u5IG_C_j0NCT8PA-z4zPIx9lKKV0sprIdvD7a_Wq9a0Ugl9wXbSqK7pjPZv2E4I4Zu9Vuode1_Kw7ZavTc7Nv-YacrTH74g_OV54o84VcrxPALxCvG4AtFxrcdThsIHrBgrDrxfec0n5HPi-bSMMFXoR-QRaMjzI1JFuh4w5Z7yOEKdN9YRCZb1A3ubYCx49Tov2f23r78P35u7nze3hy93TdTa1SZGqS1aa50XGiGiSx10XRLe2Zh0HKLpbFTGRJvUHqzv7eB9b7xLfe8c6Ev26YW70PzvjKWGh_lM03YyKKn2wnvttpB4CUWaSyFMYaF8AlqDFOHZahAybFaDV8GEZ6tb5fMrF0qEMRFMMZf_PW07tz2tnwDbkXpO</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>212709938</pqid></control><display><type>article</type><title>Morning peak in ventricular tachyarrhythmias detected by time of implantable cardioverter/defibrillator therapy</title><source>EZB-FREE-00999 freely available EZB journals</source><creator>TOFLER, G. H ; GEBARA, O. C. E ; MITTLEMAN, M. A ; TAYLOR, P ; SIEGEL, W ; VENDITTI, F. J ; RASMUSSEN, C. A ; MULLER, J. E</creator><creatorcontrib>TOFLER, G. H ; GEBARA, O. C. E ; MITTLEMAN, M. A ; TAYLOR, P ; SIEGEL, W ; VENDITTI, F. J ; RASMUSSEN, C. A ; MULLER, J. E</creatorcontrib><description>Background
A morning peak in occurrence of sudden cardiac death has been identified in epidemiological studies, but the studies are subject to selection bias, with the exclusion of unwitnessed deaths, which are more likely to occur at night. The recent availability of implantable cardioverter/defibrillators that record the time of ventricular tachyarrhythmias requiring either pacing or shock therapy provides an opportunity to clarify the timing of ventricular tachyarrhythmias predisposing to sudden cardiac death. Analysis of the timing of arrhythmias in different patient subgroups, such as patients with poor left ventricular function, may provide further insight into the mechanism of onset of sudden cardiac death.
Methods and Results
We studied patients in whom a cardioverter/defibrillator (Ventak PRx) was implanted between September 1990 and September 1993 in US centers. Events that could be timed occurred in 483 patients. With an RR cycle length of 240 ms as a cutoff, corresponding to a heart rate of 250 beats per minute, episodes were categorized as rapid (n=1217) or less rapid (n=9266) ventricular tachyarrhythmias. A higher proportion of both rapid and less rapid ventricular tachyarrhythmias began in the late morning compared with other times of the day. The subgroup of patients with ejection fraction <20% at the time of implantation demonstrated a more uniform 24-hour distribution of tachycardias ≤250 beats per minute than patients with higher left ventricular ejection fraction.
Conclusions
Further investigation of the late morning peak and of precipitants of ventricular tachyarrhythmias by use of data from the implantable cardioverter/defibrillator may provide insight into the pathophysiological mechanisms causing sudden cardiac death.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.CIR.92.5.1203</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Biological and medical sciences ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Heart ; Medical sciences</subject><ispartof>Circulation (New York, N.Y.), 1995-09, Vol.92 (5), p.1203-1208</ispartof><rights>1995 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Sep 1, 1995</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c338t-cc136e6668903eace8f4a44f0986cf3cdc546c255c6f27a69b6d99b598fbb88a3</citedby><cites>FETCH-LOGICAL-c338t-cc136e6668903eace8f4a44f0986cf3cdc546c255c6f27a69b6d99b598fbb88a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3648668$$DView record in Pascal Francis$$Hfree_for_read</backlink></links><search><creatorcontrib>TOFLER, G. H</creatorcontrib><creatorcontrib>GEBARA, O. C. E</creatorcontrib><creatorcontrib>MITTLEMAN, M. A</creatorcontrib><creatorcontrib>TAYLOR, P</creatorcontrib><creatorcontrib>SIEGEL, W</creatorcontrib><creatorcontrib>VENDITTI, F. J</creatorcontrib><creatorcontrib>RASMUSSEN, C. A</creatorcontrib><creatorcontrib>MULLER, J. E</creatorcontrib><title>Morning peak in ventricular tachyarrhythmias detected by time of implantable cardioverter/defibrillator therapy</title><title>Circulation (New York, N.Y.)</title><description>Background
A morning peak in occurrence of sudden cardiac death has been identified in epidemiological studies, but the studies are subject to selection bias, with the exclusion of unwitnessed deaths, which are more likely to occur at night. The recent availability of implantable cardioverter/defibrillators that record the time of ventricular tachyarrhythmias requiring either pacing or shock therapy provides an opportunity to clarify the timing of ventricular tachyarrhythmias predisposing to sudden cardiac death. Analysis of the timing of arrhythmias in different patient subgroups, such as patients with poor left ventricular function, may provide further insight into the mechanism of onset of sudden cardiac death.
Methods and Results
We studied patients in whom a cardioverter/defibrillator (Ventak PRx) was implanted between September 1990 and September 1993 in US centers. Events that could be timed occurred in 483 patients. With an RR cycle length of 240 ms as a cutoff, corresponding to a heart rate of 250 beats per minute, episodes were categorized as rapid (n=1217) or less rapid (n=9266) ventricular tachyarrhythmias. A higher proportion of both rapid and less rapid ventricular tachyarrhythmias began in the late morning compared with other times of the day. The subgroup of patients with ejection fraction <20% at the time of implantation demonstrated a more uniform 24-hour distribution of tachycardias ≤250 beats per minute than patients with higher left ventricular ejection fraction.
Conclusions
Further investigation of the late morning peak and of precipitants of ventricular tachyarrhythmias by use of data from the implantable cardioverter/defibrillator may provide insight into the pathophysiological mechanisms causing sudden cardiac death.</description><subject>Biological and medical sciences</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>Heart</subject><subject>Medical sciences</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><recordid>eNo9kE1r3DAQhkVoods09x5F6dWOPiytdCxLmwZSCqU5i7E86ir12u5IG_C_j0NCT8PA-z4zPIx9lKKV0sprIdvD7a_Wq9a0Ugl9wXbSqK7pjPZv2E4I4Zu9Vuode1_Kw7ZavTc7Nv-YacrTH74g_OV54o84VcrxPALxCvG4AtFxrcdThsIHrBgrDrxfec0n5HPi-bSMMFXoR-QRaMjzI1JFuh4w5Z7yOEKdN9YRCZb1A3ubYCx49Tov2f23r78P35u7nze3hy93TdTa1SZGqS1aa50XGiGiSx10XRLe2Zh0HKLpbFTGRJvUHqzv7eB9b7xLfe8c6Ev26YW70PzvjKWGh_lM03YyKKn2wnvttpB4CUWaSyFMYaF8AlqDFOHZahAybFaDV8GEZ6tb5fMrF0qEMRFMMZf_PW07tz2tnwDbkXpO</recordid><startdate>19950901</startdate><enddate>19950901</enddate><creator>TOFLER, G. H</creator><creator>GEBARA, O. C. E</creator><creator>MITTLEMAN, M. A</creator><creator>TAYLOR, P</creator><creator>SIEGEL, W</creator><creator>VENDITTI, F. J</creator><creator>RASMUSSEN, C. A</creator><creator>MULLER, J. E</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope></search><sort><creationdate>19950901</creationdate><title>Morning peak in ventricular tachyarrhythmias detected by time of implantable cardioverter/defibrillator therapy</title><author>TOFLER, G. H ; GEBARA, O. C. E ; MITTLEMAN, M. A ; TAYLOR, P ; SIEGEL, W ; VENDITTI, F. J ; RASMUSSEN, C. A ; MULLER, J. E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c338t-cc136e6668903eace8f4a44f0986cf3cdc546c255c6f27a69b6d99b598fbb88a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Biological and medical sciences</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology. Vascular system</topic><topic>Heart</topic><topic>Medical sciences</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>TOFLER, G. H</creatorcontrib><creatorcontrib>GEBARA, O. C. E</creatorcontrib><creatorcontrib>MITTLEMAN, M. A</creatorcontrib><creatorcontrib>TAYLOR, P</creatorcontrib><creatorcontrib>SIEGEL, W</creatorcontrib><creatorcontrib>VENDITTI, F. J</creatorcontrib><creatorcontrib>RASMUSSEN, C. A</creatorcontrib><creatorcontrib>MULLER, J. E</creatorcontrib><collection>Pascal-Francis</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>TOFLER, G. H</au><au>GEBARA, O. C. E</au><au>MITTLEMAN, M. A</au><au>TAYLOR, P</au><au>SIEGEL, W</au><au>VENDITTI, F. J</au><au>RASMUSSEN, C. A</au><au>MULLER, J. E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Morning peak in ventricular tachyarrhythmias detected by time of implantable cardioverter/defibrillator therapy</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><date>1995-09-01</date><risdate>1995</risdate><volume>92</volume><issue>5</issue><spage>1203</spage><epage>1208</epage><pages>1203-1208</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Background
A morning peak in occurrence of sudden cardiac death has been identified in epidemiological studies, but the studies are subject to selection bias, with the exclusion of unwitnessed deaths, which are more likely to occur at night. The recent availability of implantable cardioverter/defibrillators that record the time of ventricular tachyarrhythmias requiring either pacing or shock therapy provides an opportunity to clarify the timing of ventricular tachyarrhythmias predisposing to sudden cardiac death. Analysis of the timing of arrhythmias in different patient subgroups, such as patients with poor left ventricular function, may provide further insight into the mechanism of onset of sudden cardiac death.
Methods and Results
We studied patients in whom a cardioverter/defibrillator (Ventak PRx) was implanted between September 1990 and September 1993 in US centers. Events that could be timed occurred in 483 patients. With an RR cycle length of 240 ms as a cutoff, corresponding to a heart rate of 250 beats per minute, episodes were categorized as rapid (n=1217) or less rapid (n=9266) ventricular tachyarrhythmias. A higher proportion of both rapid and less rapid ventricular tachyarrhythmias began in the late morning compared with other times of the day. The subgroup of patients with ejection fraction <20% at the time of implantation demonstrated a more uniform 24-hour distribution of tachycardias ≤250 beats per minute than patients with higher left ventricular ejection fraction.
Conclusions
Further investigation of the late morning peak and of precipitants of ventricular tachyarrhythmias by use of data from the implantable cardioverter/defibrillator may provide insight into the pathophysiological mechanisms causing sudden cardiac death.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><doi>10.1161/01.CIR.92.5.1203</doi><tpages>6</tpages></addata></record> |
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| ispartof | Circulation (New York, N.Y.), 1995-09, Vol.92 (5), p.1203-1208 |
| issn | 0009-7322 1524-4539 |
| language | eng |
| recordid | cdi_proquest_journals_212709938 |
| source | EZB-FREE-00999 freely available EZB journals |
| subjects | Biological and medical sciences Cardiac dysrhythmias Cardiology. Vascular system Heart Medical sciences |
| title | Morning peak in ventricular tachyarrhythmias detected by time of implantable cardioverter/defibrillator therapy |
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