Atrial Fibrillation in Patients With an Implantable Cardioverter Defibrillator and Coronary Artery Disease.

Rationale: Post-myocardial infarction patients with reduced left ventricular ejection fraction (LVEF) are indicated for Implantable Cardioverter-Defibrillator (ICD) therapy as primary prevention for sudden cardiac death (SCD). Timely detection of atrial fibrillation (AF) in ICD patients is clinically important for appropriate treatment for prevention of AF related complications, most importantly stroke, heart failure and inappropriate ICD shocks. Patients with a two- or three chamber ICD and coronary artery disease (CAD) show a higher incidence of AF than age matched controls. If CAD patients with a single chamber ICD carry a similar risk for AF remains unknown. Recently, single chamber ICDs including algorithm based rhythm recorders are developed to investigate the incidence and prevalence of AF.


Objective: To investigate the incidence of new-onset AF in patients with CAD and an impaired LVEF, who will receive a single chamber ICD as primary prevention for SCD.


Study design: This study will be a multicentre observational study. Patients with CAD and

Study population: Patients, with CAD, LVEF <35% and without a history of AF, who are indicated for a single chamber ICD as primary prevention for SCD.


Intervention: Patients will, as per guideline recommendation, receive a single chamber ICD with an algorithm based rhythm recorder.


Main study parameters: Main study parameters are new-onset or silent AF.


The study with regard to a broader research plan: This study will underscore the importance of AF detection in single chamber ICD patients, remote patient monitoring and improvement of patient care. Thereby it may serve as a pilot study for upcoming large international trials on AF detection algorithm in patients with single chamber ICDs.

To investigate the incidence of new-onset AF in patients with coronary artery disease and an impaired LVEF, who will receive a single chamber ICD as primary prevention for sudden cardiac death.

Standard ICD interrogation will take place on a quarterly basis. The occurrence of AF will be monitored via remote monitoring and documented in the eCRF every month, during one year or until we reach an event rate of 10% and 20%.

Patients with CAD and