Key result
A history of catheter ablation of atrial fibrillation was an independent predictor of high reactive atrial-based antitachycardia pacing efficacy (OR 3.45; p=0.038).
Why the study?
Clinical factors associated with successful reactive atrial-based antitachycardia pacing (rATP) in patients with CIEDs were unknown.
Does a history of catheter ablation of atrial fibrillation improve the efficacy of reactive atrial-based antitachycardia pacing in patients with cardiac implantable electronic devices?
Observational (n=51)
Does a history of catheter ablation of atrial fibrillation improve the efficacy of reactive atrial-based antitachycardia pacing in patients with cardiac implantable electronic devices?
Odds Ratio: 3.45
Absolute Event Rate: 53.9% vs 36.4%
p-value: p=.038
A history of catheter ablation for atrial fibrillation significantly predicts higher efficacy of reactive atrial-based antitachycardia pacing in patients with cardiac implantable electronic devices.
AF ablation history was associated with higher rATP efficacy in CIED patients; hypothesis-generating and requires prospective validation.
INTRODUCTION: Reactive atrial-based antitachycardia pacing (rATP) in patients with cardiac implantable electronic devices (CIEDs) suppresses the progression of atrial fibrillation (AF) to the persistent form. However, the clinical factors associated with successful reactive atrial-based antitachycardia pacing (rATP) treatment are unknown. This study aimed to examine the predictors of high rATP efficacy in patients with CIEDs. METHODS: The data of 101,325 rATP-treated atrial tachyarrhythmia (AT/AF) episodes in 51 patients, obtained through remote monitoring and device interrogation, were analyzed. The study population was divided into the high and low efficacy groups based on the overall median success rate of rATP. Clinical characteristics were compared between the two groups. RESULTS: During a follow-up period of 28.6 ± 8.6 months, the median success rate was 43.7% (31.5%-64.9%). The prevalence of a history of catheter ablation of AF was significantly higher in the high efficacy group than in the low efficacy group (73.0% vs. 44.0%, p = .048) and was the only independent predictor of high rATP efficacy (odds ratio, 3.45; p = .038). The rATP success rate in patients with (n = 30) and without (n = 21) a history of catheter ablation was 53.9% (40.0%-67.5%) and 36.4% (22.2%-47.7%), respectively (p = .012). The effect of rATP after ablation was more pronounced in patients with long cycle length episodes (≥75% of AT/AF sequences having a cycle length of 200-449 ms) (67.3% [46.0%-73.6%] vs. 30.6% [18.1%-60.3%], p = .027). The high efficacy group had a significantly lower incidence of AT/AF lasting ≥1, ≥7, and ≥30 days than the low efficacy group. CONCLUSION: rATP combined with catheter ablation therapy is effective in suppressing AT/AF.
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Nakagomi et al. (2022) conducted an observational in Atrial tachyarrhythmia in patients with cardiac implantable electronic devices (n=51). History of catheter ablation of atrial fibrillation vs. No history of catheter ablation of atrial fibrillation was evaluated on High reactive atrial-based antitachycardia pacing (rATP) efficacy (OR 3.45, p=.038). A history of catheter ablation of atrial fibrillation was an independent predictor of high reactive atrial-based antitachycardia pacing efficacy (OR 3.45; p=0.038).
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