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

Abstract

This 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.

Myocardial Minimal Damage After Rapid Ventricular Pacing – the prospective randomized multicentre MyDate-Trial

“…However, because our trial was www.nature.com/scientificreports www.nature.com/scientificreports/ designed as an acute study, we are not able to conclude on potential long-term effects of ATP on morbidity and mortality. The use of ATP is well established in ICD therapy, being known for its efficient and painfree termination of slow as well as fast ventricular tachycardias, while reducing ICD shocks and patient discomfort at the same time 1,2,[10][11][12][13] . However, the ongoing international discussion of whether or not ICD therapies themselves lead to an increase in mortality expanded from the initially targeted ICD shocks to ATP.…”

Long-Term Efficacy of Implantable Cardioverter Defibrillator in Repaired Tetralogy of Fallot ― Role of Anti-tachycardia Pacing ―

“…9 Traditionally, a single burst pacing sequence has been used in fast VT. Several recent studies have shown that multiple burst pacing sequences for fast VT (cycle length 250-320 ms) are safe and effective in ICD recipients. 10- 12 Sivagangabalan et al showed that ATP efficacy was low in very fast VT (cycle length 200-250 ms). 13 The safety of ATP delivery needs to be considered in very fast VT.…”

Considering the Need to Expand the Indications for Wearable Defibrillator Therapy

“…Further, it is likely that the capability and strengths of ATP as a therapy have not been fully explored to date. 34,35 As a personal preference, a device with ATP capability in the absence of compelling circumstances (e.g., patient preference, access issues) is favored over a subcutaneous device given the effectiveness of ATP. The advent of complex multicomponent systems to address the pacing and ATP deficiencies of the existing subcutaneous ICD is-in this clinician's mind-a needlessly complex, expensive, and unwelcome mouse trap 36,37 (see Figure 6 of Lau et al 37 ).…”