Document Detail

Optimizing implantable cardioverter-defibrillator treatment of rapid ventricular tachycardia: antitachycardia pacing therapy during charging.
MedLine Citation:
PMID:  17599671     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Previous studies in implantable cardioverter-defibrillator (ICD) patients demonstrated the efficacy and safety of antitachycardia pacing (ATP) for rapid ventricular tachycardias (VT). To prevent shock delay in case of ATP failure, a new feature (ATP during charging) was developed to deliver ATP for rapid VT while charging for shock. OBJECTIVE: The purpose of this study was to determine the efficacy and safety of this new feature. METHODS: In a prospective, nonrandomized trial, patients with standard ICD indication received an EnTrust ICD. VT and ventricular fibrillation (VF) episodes were reviewed for appropriate detection, ATP success, rhythm acceleration, and related symptoms. RESULTS: In 421 implanted patients, 116 VF episodes occurred in 37 patients. Eighty-four (72%) episodes received ATP during or before charging. ATP prevented a shock in 58 (69%) of 84 episodes in 15 patients. ATP stopped significantly more monomorphic (77%) than polymorphic VTs (44%, P = .05). Five (6%) episodes accelerated after ATP but were terminated by the backup shock(s). No symptoms were related to ATP during charging. In four patients, 38 charges were saved by delivering ATP before charging. Of 98 induced VF episodes, 28% were successfully terminated by ATP versus 69% for spontaneous episodes (P <.01). CONCLUSION: Most VTs detected in the VF zone can be painlessly terminated by ATP delivered during charging, with a low risk of acceleration or symptoms. ATP before charging allows delivery of two ATP attempts before shock in the same time that would otherwise be required to deliver only one ATP plus a shock. It also offers potential battery energy savings.
Wolfgang Schoels; David Steinhaus; W Ben Johnson; Gilles O'hara; Joerg O Schwab; Inge Jenniskens; Paul J Degroot; Feng Tang; Erhard Helmling;
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2007-03-12
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  4     ISSN:  1547-5271     ISO Abbreviation:  Heart Rhythm     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-29     Completed Date:  2007-08-02     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  879-85     Citation Subset:  IM    
Evangelisches und Johanniter Klinikum Niederrhein GmbH, Herzzentrum Duisburg, Klinik für Kardiologie und Angiologie, Duisburg, Germany.
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MeSH Terms
Aged, 80 and over
Cardiac Pacing, Artificial / methods*
Defibrillators, Implantable*
Middle Aged
Tachycardia, Ventricular / therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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