Correlation of Geomagnetic Activity With Implantable Cardioverter Defibrillator Shocks and Antitachycardia Pacing

• Published in: Mayo Clinic proceedings Vol. 90; no. 2; pp. 202 - 208
• Main Authors: Ebrille, Elisa, MD, Konecny, Tomas, MD, PhD, Konecny, Dana, MD, Spacek, Radim, MD, Jones, Paul, MSc, Ambroz, Pavel, CSc, DeSimone, Christopher V., MD, PhD, Powell, Brian D., MD, Hayes, David L., MD, Friedman, Paul A., MD, Asirvatham, Samuel J., MD
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.02.2015; Frontline Medical Communications Inc; Elsevier Limited
• Subjects: Aged; Arrhythmias, Cardiac - physiopathology; Arrhythmias, Cardiac - therapy; Defibrillators, Implantable; Electric Countershock - methods; Female; Geomagnetic fields; Health aspects; Humans; Implantable cardioverter-defibrillators; Internal Medicine; Magnetic Phenomena; Magnetic properties; Male; Middle Aged; Monitoring, Physiologic; Retrospective Studies; United States; implantable cardioverter defibrillator; antitachycardia pacing; geomagnetic activity; CRT-D; GMA; ICD; ATP; cardiac resynchronization therapy–defibrillator
• ISSN: 0025-6196; 1942-5546
• DOI: 10.1016/j.mayocp.2014.11.011

Abstract Objective To investigate a potential relationship between implantable cardioverter defibrillator (ICD) therapies and daily geomagnetic activity (GMA) recorded in a large database. Patients and Methods The ALTITUDE database, derived from the Boston Scientific LATITUDE remote monitoring system, was retrospectively analyzed for the frequency of ICD therapies. Daily GMA was expressed as the planetary K-index and the integrated A-index and was graded as levels I (quiet), II (unsettled), III (active), and IV (storm). Results A daily mean ± SD of 59,468±11,397 patients were monitored between January 1, 2009, and May 15, 2012. The distribution of days according to GMA was as follows: level I, 924/1231 (75%); level II, 226/1231 (18%); level III, 60/1231 (5%); and level IV, 21/1231 (2%). The daily mean ± SD numbers of ICD shocks received per 1000 active patients in the database were 1.29±0.47, 1.17±0.46, 1.03±0.37, and 0.94±0.29 on level I, II, III, and IV days, respectively; the daily mean ± SD sums of shocks and antitachycardia pacing therapies were 9.29±2.86, 8.46±2.45, 7.92±1.80, and 7.83±2.28 on quiet, unsettled, active, and storm days, respectively. A significant inverse relationship between GMA and frequency of ICD therapies was identified, with the most pronounced difference between level I and level IV days ( P <.001 for shocks; P =.008 for shocks + antitachycardia pacing). Conclusion In a large-scale cohort analysis, ICD therapies were delivered less frequently on days of higher GMA, confirming the previous pilot data and suggesting that higher GMA does not pose an increased risk of arrhythmias using ICD therapies as a surrogate marker. Further studies are needed to gain an in-depth understanding of the underlying mechanisms.