Shock Reduction With Multiple Bursts of Antitachycardia Pacing Therapies to Treat Fast Ventricular Tachyarrhythmias in Patients With Implantable Cardioverter Defibrillators: A Multicenter Study

被引:14
作者
Anguera, Ignasi [1 ]
Dallaglio, Paolo [1 ]
Martinez-Ferrer, Jose [2 ]
Rodriguez, Anibal [3 ]
Alzueta, Javier [4 ]
Perez-Villacastin, Julian [5 ]
Porres, Jose Manuel [6 ]
Vinolas, Xavier [7 ]
Fontenla, Adolfo [8 ]
Fernandez-Lozano, Ignacio [9 ]
Garcia-Alberola, Arcadio [10 ]
Sabate, Xavier [1 ]
机构
[1] Bellvitge Univ Hosp, Bellvitge Biomed Res Inst IDIBELL, Heart Dis Inst, Dept Cardiol, Barcelona, Spain
[2] Hosp Univ Araba, Dept Cardiol, Vitoria, Spain
[3] Hosp Univ Canarias, Dept Cardiol, Santa Cruz De Tenerife, Spain
[4] Hosp Virgen de la Victoria, Dept Cardiol, Malaga, Spain
[5] Hosp Clin San Carlos, Dept Cardiol, Madrid, Spain
[6] Hosp Univ Donostia, Dept Cardiol, San Sebastian, Spain
[7] Hosp Santa Creu & Sant Pau, Dept Cardiol, Barcelona, Spain
[8] Hosp 12 Octubre, Dept Cardiol, E-28041 Madrid, Spain
[9] Hosp Univ Puerta de Hierro, Dept Cardiol, Majadahonda, Spain
[10] Hosp Univ Virgen de la Arrixaca, Dept Cardiol, Murcia, Spain
关键词
antitachycardia pacing; CareLink monitoring system; ICD shocks; implantable cardioverter defibrillator; Umbrella study; ventricular tachycardia; PRIMARY-PREVENTION; HEART-FAILURE; TACHYCARDIA; TRIAL; ALGORITHMS; EFFICACY; SAFETY;
D O I
10.1111/jce.12699
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Multiple Bursts for Fast Ventricular Tachycardia IntroductionAn empirical sequence of burst antitachycardia pacing (ATP) is effective in terminating fast ventricular tachycardias (FVT) in patients with implantable cardioverter-defibrillators (ICDs). We aimed to determine whether multiple ATP bursts for termination of FVT results in shock reduction compared to a single ATP burst. Methods and ResultsWe analyzed data from the Umbrella trial, a multicenter prospective observational study of ICD patients followed by the CareLink Monitoring System. We compared the safety and effectiveness of a single ATP burst (Group 1) with a strategy of successive ATP sequences (Group 2) for termination of FVT episodes (cycle lengths 250-320 milliseconds) before shock therapy. Over a mean follow-up of 35 months, a total of 650 FVT episodes were detected in 154 patients (mean cycle length: 299 18 milliseconds). Effectiveness of the first burst ATP in Group 1 was 73% and shocks were required in 27% of episodes. Effectiveness of the first burst ATP in Group 2 was 77%, and this increased to 91% with the third or successive ATP bursts. Shocks were required in 9% of episodes in group 2, representing a 67% reduction in the need of high-energy shocks. Median duration of FVT episodes and mortality in both groups were similar. Multivariate analysis indicated that programming multiple ATP bursts (OR 3.4, 95%CI 1.7-6.8, P = 0.001) was an independent predictor of ATP effectiveness. ConclusionThis study provides first evidence that a strategy of multiple burst ATP sequences for termination of FVT episodes leads to a clinically meaningful reduction in the need for shocks.
引用
收藏
页码:774 / 782
页数:9
相关论文
共 29 条
[11]   Fast ventricular tachycardias in patients with implantable cardioverter-defibriffators:: Efficacy and safety of antitachycardia pacing -: A prospective and randomized study [J].
Jiménez-Candil, J ;
Arenal, A ;
García-Alberola, A ;
Ortiz, M ;
del Castillo, S ;
Fernández-Portales, J ;
Sánchez-Muñoz, J ;
Martínez-Sánchez, J ;
González-Torrecilla, E ;
Atienza, F ;
Puchol, A ;
Almendral, J .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2005, 45 (03) :460-461
[12]   Safety and efficacy of programming a high number of antitachycardia pacing attempts for fast ventricular tachycardia: a prospective study [J].
Martins, Raphael P. ;
Blangy, Hugues ;
Muresan, Lucian ;
Freysz, Luc ;
Groben, Laurent ;
Zinzius, Pierre-Yves ;
Schwartz, Jerome ;
Sellal, Jean-Marc ;
Aliot, Etienne ;
Sadoul, Nicolas .
EUROPACE, 2012, 14 (10) :1457-1464
[13]  
McAnulty J, 1997, NEW ENGL J MED, V337, P1576
[14]  
Moss AJ, 1996, NEW ENGL J MED, V335, P1993
[15]   Randomized, prospective comparison of four burst pacing algorithms for spontaneous ventricular tachycardia [J].
Peinado, R ;
Almendral, J ;
Rius, T ;
Moya, A ;
Merino, JL ;
Martínez-Alday, J ;
Pérez-Villacastín, J ;
Pastor, A ;
Delcán, JL .
AMERICAN JOURNAL OF CARDIOLOGY, 1998, 82 (11) :1422-+
[16]   Prognostic importance of defibrillator shocks in patients with heart failure [J].
Poole, Jeanne E. ;
Johnson, George W. ;
Hellkamp, Anne S. ;
Anderson, Jill ;
Callans, David J. ;
Raitt, Merritt H. ;
Reddy, Ramakota K. ;
Marchlinski, Francis E. ;
Yee, Raymond ;
Guarnieri, Thomas ;
Talajic, Mario ;
Wilber, David J. ;
Fishbein, Daniel P. ;
Packer, Douglas L. ;
Mark, Daniel B. ;
Lee, Kerry L. ;
Bardy, Gust H. .
NEW ENGLAND JOURNAL OF MEDICINE, 2008, 359 (10) :1009-1017
[17]   Mortality Reduction in Relation to Implantable Cardioverter Defibrillator Programming in the Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT) [J].
Ruwald, Anne-Christine ;
Schuger, Claudio ;
Moss, Arthur J. ;
Kutyifa, Valentina ;
Olshansky, Brian ;
Greenberg, Henry ;
Cannom, David S. ;
Estes, N. A. Mark ;
Ruwald, Martin H. ;
Huang, David T. ;
Klein, Helmut ;
McNitt, Scott ;
Beck, Christopher A. ;
Goldstein, Robert ;
Brown, Mary W. ;
Kautzner, Josef ;
Shoda, Morio ;
Wilber, David ;
Zareba, Wojciech ;
Daubert, James P. .
CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, 2014, 7 (05) :785-792
[18]   Programming Antitachycardia Pacing for Primary Prevention in Patients With Implantable Cardioverter Defibrillators: Results From the PROVE Trial [J].
Saeed, Mohammad ;
Neason, Curtis G. ;
Razavi, Mehdi ;
Chandiramani, Shanker ;
Alonso, Joseph ;
Natarajan, Senthil ;
Ip, John H. ;
Peress, Darren F. ;
Ramadas, Sumati ;
Massumi, Ali .
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2010, 21 (12) :1349-1354
[19]   Prospective multicenter randomized trial of fast ventricular tachycardia termination by prolonged versus conventional anti-tachyarrhythmia burst pacing in implantable cardioverter-defibrillator patients-Atp DeliVery for pAiNless ICD thErapy (ADVANCE-D) Trial results [J].
Santini, Massimo ;
Lunati, Maurizio ;
Defaye, Pascal ;
Mermi, Johann ;
Proclemer, Alessandro ;
del Castillo-Arroys, Silvia ;
Molon, Giulio ;
De Santo, Tiziana ;
Santi, Elisabetta ;
Navarro, Xavier ;
Kloppe, Axel .
JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, 2010, 27 (02) :127-135
[20]   Optimizing implantable cardioverter-defibrillator treatment of rapid ventricular tachycardia: Antitachycardia pacing therapy during charging [J].
Schoels, Wolfgang ;
Steinhaus, David ;
Ben Johnson, W. ;
O'Hara, Gilles ;
Schwab, Joerg O. ;
Jenniskens, Inge ;
DeGroot, Paul J. ;
Tang, Feng ;
Helmling, Erhard .
HEART RHYTHM, 2007, 4 (07) :879-885