| The magnitude of sinus cycle length change during ventricular tachycardia is predictive of successful antitachycardia pacing. | |
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MedLine Citation:
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PMID: 17100671 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Despite the wide use of antitachycardia pacing (ATP) in patients with implantable cardioverter defibrillators (ICDs), predictors of ATP success remain poorly understood. We hypothesize that the degree of sympathoexcitation, as measured by the sinus cycle length (SCL) shortening during ventricular tachycardia (VT), is a predictor of ATP success. METHODS AND RESULTS: The charts of 462 patients with dual-chamber ICDs were reviewed. A total of 88 events in 26 patients met the inclusion criteria and were analyzed. The mean SCL during the 4 seconds preceding the VT onset (SCL-baseline), and during the 4 seconds prior to ATP delivery (SCL-VT) was measured. The percent shortening in SCL was calculated as ((SCL-baseline) - (SCL-VT))/(SCL-baseline) x 100. Patients were classified into the ATP-success and ATP-failure groups depending on the VT(s) response to ATP. Using a t-test analogue for clustered data, patients in the ATP-success group exhibited a greater shortening in SCL when compared with the ATP-Failure group (5.8% compared to 4.7%, P = 0.007). The successful ATP events displayed an average SCL shortening of 6.0% compared to 1.8% in the unsuccessful ATP events (P = 0.029). When the events were analyzed, the sensitivity and specificity of a shortening in SCL of >10% in predicting ATP success were 0.29 and 1. CONCLUSION: We have shown that the SCL change during VT, a marker of the autonomic changes that accompany a tachycardia, is useful in predicting ATP success. Our findings suggest that analysis of the SCL during VT might play a role in future programming of ATP in patients with ICDs. |
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Authors:
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John F MacGregor; Stephen L Wasmund; Rakesh K Pai; Moeen Abedin; Nazem Akoum; Nathan M Segerson; Roger A Freedman; Richard C Klein; T Scott Wall; David A Rawling; Shuying Shen; Mohamed H Hamdan |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 29 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2006 Nov |
Date Detail:
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Created Date: 2006-11-14 Completed Date: 2007-02-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 1195-200 Citation Subset: IM |
Affiliation:
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University of Utah Health Sciences Center, Salt Lake City, Utah, USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac Pacing, Artificial
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statistics & numerical data* Diagnosis, Computer-Assisted / methods* Electrocardiography / methods*, statistics & numerical data* Female Humans Male Outcome Assessment (Health Care) / methods*, statistics & numerical data Reproducibility of Results Retrospective Studies Risk Assessment / methods Risk Factors Sensitivity and Specificity Tachycardia, Ventricular / diagnosis*, epidemiology, therapy* Treatment Outcome Utah / epidemiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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