Key result
Regular ventricular tachycardia was significantly more successfully terminated by anti-tachycardia pacing than irregular VT, with RR interval variability reproducibility rates of 89% and 73%.
Why the study?
Few studies have reported on ventricular tachycardia characteristics and effects of implantable cardioverter defibrillator therapy according to RR interval variability.
Does RR interval variability (regular vs irregular VT) affect the success of anti-tachycardia pacing (ATP) or shock therapy in patients with ICDs?
Observational (n=69)
Does RR interval variability (regular vs irregular VT) affect the success of anti-tachycardia pacing (ATP) or shock therapy in patients with ICDs?
Answers are grounded in this paper and cite their sources.
Anti-tachycardia pacing (ATP) is more effective for terminating regular ventricular tachycardia, whereas irregular ventricular tachycardia is more likely to terminate spontaneously.
BACKGROUND: An implantable cardioverter defibrillator (ICD) is the most reliable therapeutic device for preventing sudden cardiac death in patients with sustained ventricular tachycardia (VT). Regarding its effectiveness, targeted VT is defined based on the tachyarrhythmia cycle length. However, variations in RR interval variability of VTs may occur. Few studies have reported on VT characteristics and effects of ICD therapy according to the RR interval variability. We aimed to identify the clinical characteristics of VTs and ICD therapy effects according to the RR interval variability. METHODS: We analyzed 821 VT episodes in 69 patients with ICDs or cardiac resynchronization therapy defibrillators. VTs were classified as irregular when the difference between two successive beats was >20 ms in at least one of 10 RR intervals; otherwise, they were classified as regular. We evaluated successful termination using anti-tachycardia pacing (ATP)/shock therapy, spontaneous termination, and acceleration between regular and irregular VTs. The RR interval variability reproducibility rates were evaluated. RESULTS: Regular VT was significantly more successfully terminated than irregular VT by ATP. No significant difference was found in shock therapy or VT acceleration between the regular and irregular VTs. Spontaneous termination occurred significantly more often in irregular than in regular VT cases. The reproducibility rates of RR interval variability in each episode and in all episodes were 89% and 73%, respectively. CONCLUSIONS: ATP therapy showed greater effectiveness for regular than for irregular VT. Spontaneous termination was more common in irregular than in regular VT. RR interval variability of VTs seems to be reproducible.
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Tsukahara et al. (2021) conducted an observational in Ventricular tachycardia (n=69). Regular ventricular tachycardia vs. Irregular ventricular tachycardia was evaluated on Successful termination using anti-tachycardia pacing (ATP)/shock therapy, spontaneous termination, and acceleration. Regular ventricular tachycardia was significantly more successfully terminated by anti-tachycardia pacing than irregular VT, with RR interval variability reproducibility rates of 89% and 73%.
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