Faculty Collaboration Database

Circadian pattern of ventricular tachyarrhythmias in patients with implantable cardioverter-defibrillators. J Am Coll Cardiol 1995 Mar 15;25(4):901-7

Date

03/15/1995

Pubmed ID

7884095

DOI

10.1016/0735-1097(94)00460-8

Scopus ID

2-s2.0-0028932065 (requires institutional sign-in at Scopus site)   47 Citations

Abstract

OBJECTIVES: This study examined the temporal patterns of ventricular tachycardia detections by implantable cardioverter-defibrillators for circadian variability.

BACKGROUND: Previous studies of circadian arrhythmia patterns have been methodologically limited by very brief observational periods. Late-generation implantable cardioverter-defibrillators accurately record the times of arrhythmia detections during unlimited follow-up.

METHODS: Forty-three patients with late-generation implantable cardioverter-defibrillators were followed up for 226 +/- 179 days (mean +/- SD). The times of all recorded episodes of ventricular tachyarrhythmias were retrieved from the data log of each device during follow-up.

RESULTS: The weighted distribution of 830 ventricular tachyarrhythmia episodes from the 43 patients fit a single harmonic sine curve model with a peak between 2 and 3 P.M. (95% confidence interval 1:13 to 4:13 P.M., R = 0.75, p < 0.05). The distributions of spontaneously terminating episodes, episodes receiving device therapy, episodes receiving shocks and episodes in the absence of antiarrhythmic therapy also fit the sine curve model (all R = 0.53 and 0.73, all p < 0.05), all with peak frequencies between 2:08 and 3:09 P.M. and 95% confidence intervals for peak frequencies between 11:38 A.M. and 5:07 P.M. Episodes recorded during continuous antiarrhythmic drug therapy did not fit the model (p > 0.05).

CONCLUSIONS: The distribution of ventricular tachyarrhythmias detected by late-generation implantable cardioverter-defibrillators follows a circadian pattern, with a peak tachycardia frequency between noon and 5 P.M. This pattern was not observed in patients receiving antiarrhythmic drug therapy. Knowledge of circadian periodicity for these events has implications for patient management.

Author List

Wood MA, Simpson PM, London WB, Stambler BS, Herre JM, Bernstein RC, Ellenbogen KA

Author

Pippa M. Simpson PhD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Anti-Arrhythmia Agents
Circadian Rhythm
Defibrillators, Implantable
Female
Follow-Up Studies
Humans
Male
Middle Aged
Tachycardia, Ventricular