Antitachycardia pacing terminated 83% of VT episodes in patients with LVEF ≤30% vs 93% in those with LVEF >30% (P<0.01), but accelerated more VTs to ventricular fibrillation (10% vs 2%, P<0.01).
Cohort (n=91)
Is antitachycardia pacing safe and effective for terminating spontaneous ventricular tachycardia in ICD patients with severely depressed left ventricular function (LVEF ≤ 30%) compared to those with LVEF > 30%?
Although antitachycardia pacing has a slightly lower termination rate and higher acceleration rate to ventricular fibrillation in patients with severely depressed LVEF (≤ 30%), individual patient efficacy is comparable and backup shocks effectively rescue unresponsive episodes.
Tasa de eventos absoluta: 83% vs 93%
valor p: p=< 0.01
The purpose of this study was to investigate the efficacy and safety of antitachycardia pacing (ATP) in third-generation implantable cardioverter defibrillators (ICDs) for terminating spontaneously occurring ventricular tachycardias (VTs) in patients with severely depressed left ventricular (LV) function. Ninety-one patients with active ATP were followed for 16 +/- 13 months. During this period, 775 VT episodes occurring in 36 patients were treated by ATP. The patients were divided into two groups according to their LV ejection fraction (LVEF): group A with LVEF 30% (n = 16). There were no differences between both groups in age, gender, underlying heart disease, indication for ICD therapy, or drug therapy. The VT rates were comparable (group A: 183 +/- 16 beats/min; group B: 180 +/- 21 beats/min; P = NS). Eighty-three percent of all episodes (n = 332) in group A and 93% of the VTs (n = 443) in group B were ATP terminated (P < 0.01). Ten percent of VTs in group A were accelerated by ATP into the ventricular fibrillation zone versus 2% in group B (P < 0.01). The individual termination rate and acceleration rate per patient were comparable in both groups. All VT episodes unresponsive to ATP were converted by backup shocks. The efficacy of first-shock therapy was similar in both groups (group A: 89%; group B: 97%; P = NS). The proportion of patients who needed at least one backup shock for unsuccessful ATP was comparable in both groups (group A: 65%; group B: 56%; P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
Heisel et al. (Sun,) conducted a cohort in Ventricular tachycardia in patients with implantable cardioverter defibrillators (n=91). Antitachycardia pacing in patients with LVEF ≤ 30% vs. Antitachycardia pacing in patients with LVEF > 30% was evaluated on Termination of ventricular tachycardia episodes by antitachycardia pacing (p=< 0.01). Antitachycardia pacing terminated 83% of VT episodes in patients with LVEF ≤30% vs 93% in those with LVEF >30% (P<0.01), but accelerated more VTs to ventricular fibrillation (10% vs 2%, P<0.01).
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