Fast ventricular tachycardias in patients with implantable cardioverter-defibrillators: Efficacy and safety of antitachycardia pacing

Abstract

The two episodes of syncope in strategy A occurred secondary to fast VT unsuccessfully treated by ATP. †Fisher exact test. CI ϭ confidence interval; CL ϭ cycle length; FVT ϭ fast ventricular tachycardia; HES ϭ high-energy shocks; OR ϭ odds ratio.

Clinical impact of defibrillation testing at the time of implantable cardioverter-defibrillator insertion

“…Similarly, a significant proportion (80-87%) of VT/fast VT episodes were successfully ATP-terminated without shock delivery, regardless of whether DT was performed. This is consistent with previous studies showing that dedicated ATP programming reduce the need for shocks to terminate VT/VF in a substantial number of patients [7,17,23]. In addition, newer devices are able to deliver ATP during energy charge when treating a VF episode, in an attempt to terminate a fast VT detected in the VF zone [24,25].…”

“…The remaining ICD parameters settings were left at the physicians' discretion and were not available for analyses. Nevertheless, the recommended ATP programming strategy was able to successfully terminate a high proportion of treated episodes in previous studies [7,17,26]. Finally, 3 patients died for unknown causes, but witnesses' reports reasonably excluded a sudden cause of death.…”

“…Device programming was performed according to patient clinical status and left at the discretion of the responsible physician, but all shocks were programmed at the highest available output of the device. However, a standardized ATP programming in the fast ventricular tachycardia (VT) zone was recommended in all patients [17]. Patients were first followed 3 months after device implantation and every 6 months thereafter.…”

“…Patients in the DT+ group were followed for a longer period than DT-patients (32 vs. 15 [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] months; p < 0.001). After adjusting the event rate by the follow-up duration, there was no significant difference in the death rate per observation year (DT+: 0.04 vs. DT-: 0.04; p = 0.91) nor in the rate of patients with ventricular arrhythmic events per observation year (DT+: 0.10 vs. DT-: 0.12; p = 0.46) ( Table 2).…”

Differences in ventricular tachyarrythmias and antitachycardia pacing effectiveness according to the ICD indication (primary versus secondary prevention): an analysis based on the stored electrograms

“…The initial ATP therapy in the fast VT zone was a single ATP sequence (5-pulse-burst pacing train at 84 % of the VT CL) [9]. Failed ATP was followed by shock and then other shocks as necessary.…”