Influence of beta-blocker therapy on antitachycardia pacing effectiveness for monomorphic ventricular tachycardias occurring in implantable cardioverter-defibrillator patients: a dose-dependent effect

Jiménez‐Candil, Javier; Hernández, Jesús; Martín, Ana; Ruiz-Olgado, María; Herrero, Jesús; Ledesma, Claudio; Moríñigo, José Luis; Martín-Luengo, Cándido

doi:10.1093/europace/euq164

Cited by 23 publications

(22 citation statements)

References 26 publications

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“…3,20,23 In the present study, the rate of VT-related symptoms was similar to others reported previously. 3,24 However, episodes with lower degrees of R-R fluctuations and/or progressive acceleration had a higher incidence of syncope or near syncope because they were associated with a lower ATP effectiveness.…”

Section: Discussionsupporting

confidence: 92%

Influence of cycle length variations on antitachycardia pacing effectiveness among ICD patients

et al. 2013

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Section: Discussionsupporting

confidence: 92%

Influence of cycle length variations on antitachycardia pacing effectiveness among ICD patients

et al. 2013

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“…In our study population, VT cycle length, ATP pacing rate, cycle length variability, and EGM‐morphology did not predict ATP efficacy. In agreement with previous reports, beta‐blockers improved the success rate of ATP. Indeed, beta‐blockers prolong the excitable gap, thereby facilitating ATP to enter in the VT circuit …”

Section: Discussionsupporting

confidence: 92%

Safety and efficacy of anti‐tachycardia pacing in patients with hypertrophic cardiomyopathy implanted with an ICD

Adduci

Semprini

Palano

et al. 2019

Pacing Clinical Electrophis

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Background In hypertrophic cardiomyopathy (HCM) patients implanted with an implantable cardioverter defibrillator (ICD), clinical outcomes of antitachycardia pacing (ATP) have been poorly explored. In a retrospective analysis of a cohort of consecutive HCM patients implanted with an ICD, we aimed to assess the efficacy, safety, and clinical value of ATP. Methods The cohort of HCM patients implanted with a transvenous ICD and followed in our center was assessed for device intervention from implantation to last clinical follow‐up. Results Overall 77 patients (45 males; mean age: 46 ± 16 years) were analyzed. After 67 ± 41 months, 24 patients had 49 ventricular tachycardia/fibrillation (VT/VF) appropriately treated (5.8% per year). Among 39 monomorphic VTs, ATP was effective in 27 (success rate: 69%). Mean time from VT onset to ATP delivery was 9.1 ± 4.9 s. The only clinical variable improving ATP success was use of beta‐blockers (81% vs 50%; P = .04). Out of 12 ineffectively treated VTs, one was immediately shocked, four self‐terminated after 18 ± 12 s, and seven (18%) were accelerated to a new VT. ATP was also delivered for 27 of 42 inappropriately detected episodes and induced two de novo VTs (7%). In the per patient analysis, 14 out 77 (18%) patients had one or more appropriate and effective ATP (3.4% per year), and only six (8%; 1.4% per year) received more than one ATP. Conclusion ATP is moderately effective for the treatment of monomorphic VTs in HCM patients. However, the rate of appropriate ATP therapies is low, ATP is often prematurely delivered, and ATP‐induced arrhythmia degeneration is of concern.

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“…19 Blockade of beta-adrenergic receptors has consequently been shown to increase ATP efficacy. 20 Pacing stimulus for ATP delivery is conventionally expressed as a percentage of the tachycardia cycle length for a given R-R interval from 0 to 100 from the onset of the preceding R wave. Pace stimulation delivered at shorter coupling intervals (ie, o85%) may be more likely to enter the circuit but also accelerate the arrhythmia 21 unless delivered in a shortened train of 5 pulses.…”

Section: Atp: Rationale For Use and Supportive Clinical Evidencementioning

confidence: 99%

Antitachycardia pacing for reduction of implantable cardioverter-defibrillator shocks

Cantillon

Wilkoff

2015

Heart Rhythm

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Influence of beta-blocker therapy on antitachycardia pacing effectiveness for monomorphic ventricular tachycardias occurring in implantable cardioverter-defibrillator patients: a dose-dependent effect

Abstract: Beta-blockers increase the effectiveness of ATP through a dose-dependent effect. As a result, they reduce the incidence of shocks due to VT.

Cited by 23 publications

References 26 publications

Influence of cycle length variations on antitachycardia pacing effectiveness among ICD patients

Influence of cycle length variations on antitachycardia pacing effectiveness among ICD patients

Safety and efficacy of anti‐tachycardia pacing in patients with hypertrophic cardiomyopathy implanted with an ICD

Antitachycardia pacing for reduction of implantable cardioverter-defibrillator shocks

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