Anti‐tachycardia pacing for non‐fast and fast ventricular tachycardias in individual Japanese patients: From Nippon‐storm study

Abstract

Background Anti‐tachycardia pacing (ATP) delivered from an implantable device is a useful tool to terminate ventricular tachycardia (VT). But its real‐world efficacy for those patients having multiple VTs with varying VT rates has not been fully studied. Methods Using the Nippon‐storm study database, efficacy of patient‐by‐patient basis ATP programing for Japanese patients having both non‐fast (120‐187 bpm) and fast VT (≥188 bpm) was assessed. According to the useful criteria of ≥50% success termination by ATP, patients were divided into three subgroups; success ≥50% for both non‐fast and fast VT (both useful), ≥50% only for non‐fast VT (non‐fast VT useful), or ≥50% for neither non‐fast nor fast VT (neither useful). Results During a median follow‐up of 28 months, ATP terminated 184 of the 203 non‐fast VT episodes (91%) and 86 of the 113 fast VT episodes (76%) in all 41 patients. In the patient‐by‐patient analysis, efficacy of ATP was not different between non‐fast and fast VT in most of the patients (36/41 = 88%); 32 patients were in the both useful and four other patients in the neither useful. Neither ischemic nor non‐ischemic structural heart disease was associated with the ATP efficacy, whereas LVEF more than 37.0% and non‐prescribed amiodarone were characteristics of the patients classified into the both useful. Conclusions ATP well terminated both non‐fast and fast VT occurring in individual Japanese patients with various structural heart diseases in the real‐world device treatment and this finding further supports ATP programing for all device tachycardia detection zones in most patients with multiple VTs.

“Carryover phenomenon” in subcutaneous implantable cardioverter‐defibrillator: Residual energy caused early shock to subsequent ventricular tachycardia

“…Anti‐tachycardia pacing (ATP) with transvenous ICD is known to be an effective tool for terminating VTs, 3 however, in this present case, there was no history of sustained VT before the operation, and non‐sustained VT was infrequent. Because the “Carryover phenomenon” was no longer observed by the countermeasures described in the discussion section, we decided not to change to transvenous ICD in this present case.…”

A real‐world experience of subcutaneous and transvenous implantable cardiac defibrillators—comparison with the PRAETORIAN study

“…ATP therapies have been found to be successful in terminating both nonfast and fast VT among patients with various structural heart diseases in the real‐world setting 36 . ATP therapy burden was higher in our TV‐ICD patients as we programmed a higher total number of ATPs to minimize shocks.…”

“…ATP therapies have been found to be successful in terminating both nonfast and fast VT among patients with various structural heart diseases in the real‐world setting. 36 ATP therapy burden was higher in our TV‐ICD patients as we programmed a higher total number of ATPs to minimize shocks. Overall, appropriate shocks from the TV‐ICDs were low and similar to the TV‐ICD group of PS, however, shocks due to VT were lower in comparison with PS TV‐ICD group which may be due to a higher rate cutoff and duration delay for detecting VT‐like MADIT‐RIT study.…”