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

Jiménez‐Candil, Javier; Hernández, Jesús; Martín, Ana; Moríñigo, José Luis; López, Rosana; Ledesma, Claudio; Martín-Luengo, Cándido

doi:10.1016/j.hrthm.2012.10.028

Cited by 18 publications

(27 citation statements)

References 21 publications

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“…17 However, our data do not support this finding, in that we observed no difference in ATP efficacy among different CL ranges. In addition, other studies have shown that the stimulation site 18,19 and R–R fluctuations 20 may also play a significant role in the ability of ATP to terminate the arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

Different impact of long-detection interval and anti-tachycardia pacing in reducing unnecessary shocks: data from the ADVANCE III trial

et al. 2016

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AimsA long-detection interval (LDI) (30/40 intervals) has been proved to be superior to a standard-detection interval (SDI) (18/24 intervals) in terms of reducing unnecessary implantable cardioverter defibrillator (ICD) therapies. To better evaluate the different impact of LDI and anti-tachycardia pacing (ATP) on reducing painful shocks, we assessed all treated episodes in the ADVANCE III trial.Methods and resultsA total of 452 fast (200 ms < cycle length ≤ 320 ms) arrhythmic episodes were recorded: 284 in 138 patients in the SDI arm and 168 in 82 patients in the LDI arm (106/452 inappropriate detections). A total of 346 fast ventricular tachycardias (FVT) were detected in 169 patients: 208 in 105 patients with SDI and 138 in 64 patients with LDI. Setting LDI determined a significant reduction in appropriate but unnecessary therapies [208 in SDI vs. 138 in LDI; incidence rate ratio (IRR): 0.61 (95% CI 0.45–0.83), P = 0.002]. Anti-tachycardia pacing determined another 52% reduction in unnecessary shocks [208 in SDI with hypothetical shock-only programming vs. 66 in LDI with ATP; IRR: 0.37 (95% CI 0.25–0.53, P < 0.001)]. The efficacy of ATP in terminating FVT was 63% in SDI and 52% in LDI (P = 0.022). No difference in the safety profile (acceleration/degeneration and death/cardiovascular hospitalizations) was observed between the two groups.ConclusionThe combination of LDI and ATP during charging is extremely effective and significantly reduces appropriate but unnecessary therapies. The use of LDI alone yielded a 39% reduction in appropriate but unnecessary therapies; ATP on top of LDI determined another 52% reduction in unnecessary shocks. The strategy of associating ATP and LDI could be considered in the majority of ICD recipients.

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Section: Discussionmentioning

confidence: 99%

Different impact of long-detection interval and anti-tachycardia pacing in reducing unnecessary shocks: data from the ADVANCE III trial

et al. 2016

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“…Almost all monomorphic VTs occurring in patients with left ventricular dysfunction (especially when the substrate is a previous myocardial infarction) are due to a reentrant mechanism . In addition, from 30% to 40% of spontaneous VT occurring in ICD patients are FVT, usually defined by a CL between 250–320 milliseconds …”

Section: Discussionmentioning

confidence: 99%

Morphology of Far‐Field Electrograms and Antitachycardia Pacing Effectiveness Among Fast Ventricular Tachycardias Occurring in ICD Patients: A Multicenter Study

Jiménez‐Candil

Anguera

Ledesma

et al. 2013

Cardiovasc electrophysiol

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“…25 In general, faster VTs have a shorter excitable gap that is more difficult for the pacing stimulus enter but not necessarily to terminate once penetrated. 26,27 Some evidence suggests that VT with spontaneous R-R interval oscillation may more likely be ATP responsive, 28 and those with greater variation in wavelet morphology perhaps less likely ATP responsive. 29 The latter fits with the concept that polymorphic ventricular tachycardia (PMVT) and ventricular fibrillation (VF) are effectively non-pace terminable because of the lack of organized reentry.…”

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 cycle length variations on antitachycardia pacing effectiveness among ICD patients

Cited by 18 publications

References 21 publications

Different impact of long-detection interval and anti-tachycardia pacing in reducing unnecessary shocks: data from the ADVANCE III trial

Different impact of long-detection interval and anti-tachycardia pacing in reducing unnecessary shocks: data from the ADVANCE III trial

Morphology of Far‐Field Electrograms and Antitachycardia Pacing Effectiveness Among Fast Ventricular Tachycardias Occurring in ICD Patients: A Multicenter Study

Antitachycardia pacing for reduction of implantable cardioverter-defibrillator shocks

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