Document Detail


Antitachycardia Pacing Reduces Appropriate and Inappropriate Shocks in Children and Congenital Heart Disease Patients.
MedLine Citation:
PMID:  22766560     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Antitachycardia pacing (ATP) can reduce implantable cardioverter-defibrillator (ICD) shocks, but its use in children and congenital heart disease (CHD) patients is not well described. OBJECTIVE: To review the efficacy of ATP in children and CHD patients. METHODS: We reviewed ICD therapies in children and CHD patients (age 2-52 years) at our institution. Appropriate therapies were defined as those delivered for true ventricular tachycardia (VT) or fibrillation (VF); other therapies were defined as inappropriate. RESULTS: During a median follow up of 4 years (range 0.5-15 years), 17/79 patients (23%) received appropriate therapy, and 14 received ATP for 100 episodes of VT. ATP was highly successful (88%) in terminating VT, and only 10/100 episodes required a shock. Shocks were effective in terminating VT/VF in 21/24 episodes (87%). The outcomes of appropriate therapy were similar for ATP compared to shocks (success 88% vs. 87%, failure 9% vs. 8%, acceleration 3% vs. 4% for ATP and shocks respectively). Thirty-one patients (39%) received inappropriate therapy. Inappropriate ATP (without subsequent shocks) was delivered to 11 patients for the following: sinus tachycardia (19 episodes in 7 patients) with slowing of the rate after ATP, T-wave oversensing (2 episodes in 2 patients) with loss of oversensing after ATP, and reentrant supraventricular tachycardia (14 episodes in 2 patients) terminated with ventricular ATP. CONCLUSIONS: ATP is highly efficacious for VT in children and CHD patients. In addition to reducing appropriate shocks, inappropriate shocks due to sinus or supraventricular tachycardia can be significantly reduced with ATP.
Authors:
Yuvraj Kalra; Andrew E Radbill; James A Johns; Frank A Fish; Prince J Kannankeril
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-2
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
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