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Additional antitachycardia pacing programming strategies further reduce unnecessary implantable cardioverter-defibrillator shocks.

Publication ,  Journal Article
Joung, B; Lexcen, DR; Ching, C-K; Silver, MT; Piccini, JP; Sterns, LD; Rabinovich, R; Pickett, RA; Liu, S; Brown, ML; Cheng, A
Published in: Heart Rhythm
January 2020

BACKGROUND: Antitachycardia pacing (ATP) is routinely used to terminate ventricular tachyarrhythmias (VTs). However, little guidance exists on the most effective programming of ATP. OBJECTIVE: This study evaluated whether additional ATP sequences are more effective in reducing implantable cardioverter-defibrillator shocks. METHODS: In patients from the Shock-Less study, the number of overall shocks were compared between patients programmed to ≤3 ATP sequences (VT zone) and ≤1 ATP sequence (fast ventricular tachycardia [FVT] zone) (nominal group) and patients programmed to receive additional ATP sequences in VT (>3) or FVT (>1) zones. RESULTS: Of the 4112 patients (15% receiving secondary prevention; 77% men; mean age 65.9 ± 12.6 years), 1532 patients (37%) were programmed with additional ATP sequences (1025 with >3 ATP sequences in the VT zone; 699 patients with >1 ATP sequence in the FVT zone). Over a mean follow-up period of 19.6 ± 10.7 months, 4359 VT/FVT episodes occurred in 591 patients. Compared with the nominal group, in patients with additional ATP programming, there was a 39% reduction in the number of shocked VT episodes (0.46 episodes per patient-year vs 0.28 episodes per patient-year; incidence rate ratio [IRR] 0.61; P < .001) and a 44% reduction in the number of shocked FVT episodes (0.83 episodes per patient-year vs 0.47 episodes per patient-year; IRR 0.56; P < .001). The reduction in shocked VT episodes was observed in both primary (IRR 0.68; 95% confidence interval 0.51-0.90; P = .007) and secondary (IRR 0.51; 95% confidence interval 0.35-0.72; P < .001) prevention patients. CONCLUSION: Programming more than the nominal number of ATP sequences in both the VT and FVT zones is associated with a lower occurrence of implantable cardioverter-defibrillator shocks in clinical practice.

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Published In

Heart Rhythm

DOI

EISSN

1556-3871

Publication Date

January 2020

Volume

17

Issue

1

Start / End Page

98 / 105

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Secondary Prevention
  • Prospective Studies
  • Male
  • Humans
  • Heart Rate
  • Follow-Up Studies
  • Female
  • Equipment Design
  • Electric Countershock
 

Citation

APA
Chicago
ICMJE
MLA
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Joung, B., Lexcen, D. R., Ching, C.-K., Silver, M. T., Piccini, J. P., Sterns, L. D., … Cheng, A. (2020). Additional antitachycardia pacing programming strategies further reduce unnecessary implantable cardioverter-defibrillator shocks. Heart Rhythm, 17(1), 98–105. https://doi.org/10.1016/j.hrthm.2019.07.027
Joung, Boyoung, Daniel R. Lexcen, Chi-Keong Ching, Marc T. Silver, Jonathan P. Piccini, Laurence D. Sterns, Rafael Rabinovich, et al. “Additional antitachycardia pacing programming strategies further reduce unnecessary implantable cardioverter-defibrillator shocks.Heart Rhythm 17, no. 1 (January 2020): 98–105. https://doi.org/10.1016/j.hrthm.2019.07.027.
Joung B, Lexcen DR, Ching C-K, Silver MT, Piccini JP, Sterns LD, et al. Additional antitachycardia pacing programming strategies further reduce unnecessary implantable cardioverter-defibrillator shocks. Heart Rhythm. 2020 Jan;17(1):98–105.
Joung, Boyoung, et al. “Additional antitachycardia pacing programming strategies further reduce unnecessary implantable cardioverter-defibrillator shocks.Heart Rhythm, vol. 17, no. 1, Jan. 2020, pp. 98–105. Pubmed, doi:10.1016/j.hrthm.2019.07.027.
Joung B, Lexcen DR, Ching C-K, Silver MT, Piccini JP, Sterns LD, Rabinovich R, Pickett RA, Liu S, Brown ML, Cheng A. Additional antitachycardia pacing programming strategies further reduce unnecessary implantable cardioverter-defibrillator shocks. Heart Rhythm. 2020 Jan;17(1):98–105.
Journal cover image

Published In

Heart Rhythm

DOI

EISSN

1556-3871

Publication Date

January 2020

Volume

17

Issue

1

Start / End Page

98 / 105

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Secondary Prevention
  • Prospective Studies
  • Male
  • Humans
  • Heart Rate
  • Follow-Up Studies
  • Female
  • Equipment Design
  • Electric Countershock