Empirical versus tested antitachycardia pacing in implantable cardioverter defibrillators: a prospective study including 200 patients.

نویسندگان

  • A Schaumann
  • F von zur Mühlen
  • B Herse
  • B D Gonska
  • H Kreuzer
چکیده

BACKGROUND Implantable cardioverter-defibrillators (ICDs) reduce the risk of sudden cardiac death. The objective of this study was to evaluate whether testing of antitachycardia pacing (ATP) for induced ventricular tachycardias (VTs) at predischarge examination can predict ATP success during follow-up. METHODS AND RESULTS The study covers 200 consecutive patients who received ICD implants from June 1991 through December 1995. All underwent electrophysiological testing. In 54 patients (ATP tested, group T), ATP terminated induced VTs successfully. In 146 patients (empirically programmed ATP, group E), only ventricular fibrillation could be induced, including 18 with unsuccessful ATP attempts for induced VTs. Disregarding the results of ATP testing, the same ATP scheme was programmed in all patients: three attempts of autodecremental ramp with 81% of the VT cycle length, with 8 to 10 pulses. During a follow-up of 20.4 +/- 10 months, 95% of 3819 spontaneous VTs were successfully terminated with ATP in 42 patients of group T. In group E, 90% of 1346 spontaneous VTs in 81 patients were terminated with ATP. Acceleration after ATP occurred in 2% in group T versus 5% in group E. The success for all episodes in individual patients was > or =90% in >60% of the ATP tested and empirically programmed patients. CONCLUSIONS The results of this 200-patient prospective study comparing tested versus empirical ATP show high success (95% versus 90%) for VT termination, with low rates of acceleration. ATP is safe and very effective and should be programmed "on" in all patients regardless of the predischarge EP inducibility.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Prospective randomized multicenter trial of empirical antitachycardia pacing versus shocks for spontaneous rapid ventricular tachycardia in patients with implantable cardioverter-defibrillators: Pacing Fast Ventricular Tachycardia Reduces Shock Therapies (PainFREE Rx II) trial results.

BACKGROUND Successful antitachycardia pacing (ATP) terminates ventricular tachycardia (VT) up to 250 bpm without the need for painful shocks in implantable cardioverter-defibrillator (ICD) patients. Fast VT (FVT) >200 bpm is often treated by shock because of safety concerns, however. This prospective, randomized, multicenter trial compares the safety and utility of empirical ATP with shocks for...

متن کامل

Incidence and clinical relevance of slow ventricular tachycardia in implantable cardioverter-defibrillator recipients: an international multicenter prospective study.

BACKGROUND This study aims to assess the incidence and clinical relevance of slow ventricular tachycardia (VT) and the effectiveness and/or deleterious effects of antitachycardia pacing in slow VT in implantable cardioverter-defibrillator recipients. METHODS AND RESULTS This multicenter prospective randomized study included 374 patients (326 men) without prior history of slow VT (<148 bpm) im...

متن کامل

Antitachycardia pacing to terminate ventricular tachyarrhythmia: new insights into how to reduce painful implantable cardioverter defibrillator shocks.

This editorial refers to ‘Safety and efficacy of programming a high number of antitachycardia pacing attempts for fast ventricular tachycardia: a prospective study’ by R.P. Martins et al., on page 1457 and ‘First inappropriate implantable cardioverter defibrillator therapy is often due to inaccurate device programming: analysis of the French OPERA registry’ by A. Leenhardt et al., on page 1465

متن کامل

Appropriate and Inappropriate Ventricular Therapies, Quality of Life, and Mortality Among Primary and Secondary Prevention Implantable Cardioverter Defibrillator Patients

Background—Implantable cardioverter defibrillators (ICDs) reduce mortality in primary and secondary prevention. Quality of life, mortality, appropriate therapies for specific ventricular rhythms, and inappropriate therapies for supraventricular tachycardia (SVT) were compared among 582 patients (primary prevention 248; secondary prevention 334) in PainFREE Rx II, a 634-patient prospective, rand...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Circulation

دوره 97 1  شماره 

صفحات  -

تاریخ انتشار 1998