Efficacy of automatic multimodal device therapy for ventricular tachyarrhythmias as delivered by a new implantable pacing cardioverter-defibrillator. Results of a European multicenter study of 102 implants.
Why the study?
Does the Medtronic PCD pacer-cardioverter-defibrillator effectively terminate ventricular tachyarrhythmias and improve survival in patients with refractory ventricular tachyarrhythmias?
Population
102 patients from 11 European centers with hemodynamically significant ventricular tachyarrhythmias not…
Design
Cohort
Follow-up
mean 9.4 +/- 5.8 months (range 1-21 months)
Authors
Discussion
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Implication
May reduce shocks via antitachycardia pacing in VT; leaves open randomized confirmation of survival benefit.
Key Points
- This study aims to evaluate the efficacy of a new implantable cardioverter-defibrillator device for treating ventricular tachyarrhythmias.
- Evaluated 102 patients with significant ventricular tachyarrhythmias at 11 European centers.
- Documented intraoperative and follow-up data, including ejection fraction and device therapies administered.
- Analyzed treatment outcomes based on device memory data and identified episodes of VT and VF.
- Defibrillation efficacy was 97.6%, with a sinus rhythm restoration rate of 91% for initial treatments.
- Perioperative mortality was 3.9%, and the actuarial survival rate at 12 months was 91%.
- Automatic tiered therapy effectively restored sinus rhythm, significantly reducing the incidence of sudden arrhythmic death.
Structured PICO
Does the Medtronic PCD pacer-cardioverter-defibrillator effectively terminate ventricular tachyarrhythmias and improve survival in patients with refractory ventricular tachyarrhythmias?
P
Population
102 patients from 11 European centers with hemodynamically significant ventricular tachyarrhythmias not suppressed by antiarrhythmic drug therapy and unrelated to acute myocardial infarction (one patient had nonsustained VT and severely depressed left ventricular function).
I
Intervention
Medtronic PCD pacer-cardioverter-defibrillator with epicardial patch-lead configuration
O
Outcome
Efficacy of device therapy (antitachycardia pacing, cardioversion, defibrillation) in terminating VT/VF and survival ratehard clinical
The Medtronic PCD device effectively terminates spontaneous ventricular tachyarrhythmias primarily via overdrive pacing, minimizing the need for painful shocks and nearly eliminating sudden arrhythmic death.
Cite This Study
Fromer et al. (1992) studied this question.