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Antitachycardia Pacing Therapy

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Giuseppe Boriani – One of the best experts on this subject based on the ideXlab platform.

  • Reactive atrial-based Antitachycardia Pacing Therapy reduces atrial tachyarrhythmias.
    Pacing and clinical electrophysiology : PACE, 2019
    Co-Authors: George H. Crossley, Luigi Padeletti, Steven Zweibel, J. Harrison Hudnall, Yan Zhang, Giuseppe Boriani

    Abstract:

    BACKGROUND Reactive atrial-based Antitachycardia Pacing (rATP) aims to terminate atrial tachyarrhythmia/atrial fibrillation (AT/AF) episodes when they spontaneously organize to atrial flutter or atrial tachycardia; however, its effectiveness in the real-world has not been studied. We used a large device database (Medtronic CareLink, Medtronic, Minneapolis, MN, USA) to evaluate the effects of rATP at reducing AT/AF. METHODS Pacemaker, defibrillator, and resynchronization device transmission data were analyzed. Eligible patients had device detected AT/AF during a baseline period but were not in persistent AT/AF immediately preceding first transmission. Note that 1:1 individual matching between groups was conducted using age, sex, device type, Pacing mode, AT/AF, and percent ventricular Pacing at baseline. Risks of AT/AF events were compared between patients with rATP-enabled versus control patients with rATP-disabled or not available in the device. For matched patients, AT/AF event rates at 2 years were estimated by Kaplan-Meier method, and hazard ratios (HRs) were calculated by Cox proportional hazard models. RESULTS Of 43,440 qualifying patients, 4,203 had rATP on. Matching resulted in 4,016 pairs, totaling 8,032 patients for analysis. The rATP group experienced significantly lower risks of AT/AF events lasting ≥1 day (HR 0.81), ≥7 days (HR 0.64), and ≥30 days (HR 0.56) compared to control (P 

  • Ventricular Antitachycardia Pacing Therapy in patients with heart failure implanted with a cardiac resynchronization Therapy defibrillator device: Efficacy, safety, and impact on mortality.
    Heart rhythm, 2015
    Co-Authors: Maurizio Landolina, Giuseppe Boriani, Renato Pietro Ricci, Maurizio Lunati, Alessandro Proclemer, Domenico Facchin, Roberto Rordorf, Giovanni Morani, Massimiliano Maines, Gianni Gasparini

    Abstract:

    Background Cardiac resynchronization Therapy defibrillator can terminate ventricular tachycardia (VT) and fast VT (FVT) via Antitachycardia Pacing (ATP). Objectives We evaluated efficacy and safety of ATP, whether ATP induces ventricular arrhythmias after inappropriate ATP or atrial fibrillation (AF) after appropriate ATP, and whether ATP is associated with mortality. Methods A total of 1404 patients with a cardiac resynchronization Therapy defibrillator were followed in a prospective multicenter observational research. All-cause mortality rates were estimated in patient subgroups in order to uncouple the trigger (VT/FVT or other rhythms causing inappropriate detections) from ATP Therapy. Results Over a median follow-up of 31 months, 2938 VT/FVT episodes were treated with ATP in 360 patients. The adjusted ATP success rate was 63% (95% confidence interval [CI] 57%–69%) on FVTs and 68% (95% CI 62%–74%) on VTs. Acceleration occurred in 55 (1.87%) and syncope in 4 (0.14%) of all ATP-treated episodes. In 14 true VT/FVT episodes in 5 patients, AF followed ATP Therapy. In 4 episodes in 2 patients, VT followed ATP inappropriately applied during AF. Death rate per 100 patient-years was 5.6 (95% CI 4.3–7.5) in patients with appropriate ATP and 1.5 (95% CI 0.4–6.1) in patients with inappropriate ATP (P = .045). Conclusion ATP was effective in terminating VT/FVT episodes and displayed a good safety profile. ATP therapies by themselves did not increase death risk; prognosis was indeed better in patients without arrhythmic episodes, even if they received inappropriate ATP, than in patients with ATP on VT/FVT episodes. Adverse outcomes observed in patients receiving implantable cardioverter-defibrillator therapies are probably related to the arrhythmia itself, a marker of disease progression, rather than to adverse effects of ATP.

  • Antitachycardia Pacing Therapy to treat spontaneous atrial tachyarrhythmias: the 7250 Dual Defibrillator Italian Registry
    European Heart Journal Supplements, 2001
    Co-Authors: Renato Pietro Ricci, Giuseppe Boriani, Luigi Padeletti, Carlo Pignalberi, Disertori M, Alessandro Capucci, G.l. Botto, F. Miraglia, T De Santo, Massimo Santini

    Abstract:

    Background The dual defibrillator is a new device that can deliver atrial Antitachycardia Pacing (ATP) and shock therapies to treat atrial tachyarrhythmias in patients with and without life-threatening ventricular tachyarrhythmias. The aims of the present study were to investigate the efficacy of ATP and to identify factors that may impact on success of treatment. Method A total of 105 patients (80 male, mean age 64 ± 10 years) implanted with a dual defibrillator were enrolled in the study; 66% had documented atrial fibrillation (AF) before implantation a nd 14% had no history of prior ventricular tachyarrhythmias.

Jeffrey J. Goldberger – One of the best experts on this subject based on the ideXlab platform.

  • Predictors of appropriate implantable cardioverter-defibrillator Therapy in patients with idiopathic dilated cardiomyopathy.
    The American journal of cardiology, 2002
    Co-Authors: Vladimir Rankovic, Juhana Karha, Rod S. Passman, Alan H. Kadish, Jeffrey J. Goldberger

    Abstract:

    Abstract Evaluating predictors of appropriate implantable cardioverter-defibrillator (ICD) Therapy in patients with idiopathic dilated cardiomyopathy (IDC) may be helpful in developing risk stratification strategies for these patients. Fifty-four patients with IDC underwent ICD implantation and were followed up. Twenty-three patients (42%) had a class I indication for ICD implantation; the remaining patients underwent implantation for multiple risk factors for sudden death including left ventricular dysfunction, nonsustained ventricular tachycardia, syncope, or positive electrophysiologic study results. Clinical, electrocardiographic, and electrophysiologic data were collected. Appropriate ICD Therapy was defined as an Antitachycardia Pacing Therapy or shock for tachyarrhythmia determined to be either ventricular tachycardia or ventricular fibrillation. Appropriate ICD Therapy was observed in 23 patients (42%). There was a significant difference in use of β-blocker Therapy between patients who did and did not have appropriate ICD Therapy (p

Renato Pietro Ricci – One of the best experts on this subject based on the ideXlab platform.

  • Ventricular Antitachycardia Pacing Therapy in patients with heart failure implanted with a cardiac resynchronization Therapy defibrillator device: Efficacy, safety, and impact on mortality.
    Heart rhythm, 2015
    Co-Authors: Maurizio Landolina, Giuseppe Boriani, Renato Pietro Ricci, Maurizio Lunati, Alessandro Proclemer, Domenico Facchin, Roberto Rordorf, Giovanni Morani, Massimiliano Maines, Gianni Gasparini

    Abstract:

    Background Cardiac resynchronization Therapy defibrillator can terminate ventricular tachycardia (VT) and fast VT (FVT) via Antitachycardia Pacing (ATP). Objectives We evaluated efficacy and safety of ATP, whether ATP induces ventricular arrhythmias after inappropriate ATP or atrial fibrillation (AF) after appropriate ATP, and whether ATP is associated with mortality. Methods A total of 1404 patients with a cardiac resynchronization Therapy defibrillator were followed in a prospective multicenter observational research. All-cause mortality rates were estimated in patient subgroups in order to uncouple the trigger (VT/FVT or other rhythms causing inappropriate detections) from ATP Therapy. Results Over a median follow-up of 31 months, 2938 VT/FVT episodes were treated with ATP in 360 patients. The adjusted ATP success rate was 63% (95% confidence interval [CI] 57%–69%) on FVTs and 68% (95% CI 62%–74%) on VTs. Acceleration occurred in 55 (1.87%) and syncope in 4 (0.14%) of all ATP-treated episodes. In 14 true VT/FVT episodes in 5 patients, AF followed ATP Therapy. In 4 episodes in 2 patients, VT followed ATP inappropriately applied during AF. Death rate per 100 patient-years was 5.6 (95% CI 4.3–7.5) in patients with appropriate ATP and 1.5 (95% CI 0.4–6.1) in patients with inappropriate ATP (P = .045). Conclusion ATP was effective in terminating VT/FVT episodes and displayed a good safety profile. ATP therapies by themselves did not increase death risk; prognosis was indeed better in patients without arrhythmic episodes, even if they received inappropriate ATP, than in patients with ATP on VT/FVT episodes. Adverse outcomes observed in patients receiving implantable cardioverter-defibrillator therapies are probably related to the arrhythmia itself, a marker of disease progression, rather than to adverse effects of ATP.

  • Antitachycardia Pacing Therapy to treat spontaneous atrial tachyarrhythmias: the 7250 Dual Defibrillator Italian Registry
    European Heart Journal Supplements, 2001
    Co-Authors: Renato Pietro Ricci, Giuseppe Boriani, Luigi Padeletti, Carlo Pignalberi, Disertori M, Alessandro Capucci, G.l. Botto, F. Miraglia, T De Santo, Massimo Santini

    Abstract:

    Background The dual defibrillator is a new device that can deliver atrial Antitachycardia Pacing (ATP) and shock therapies to treat atrial tachyarrhythmias in patients with and without life-threatening ventricular tachyarrhythmias. The aims of the present study were to investigate the efficacy of ATP and to identify factors that may impact on success of treatment. Method A total of 105 patients (80 male, mean age 64 ± 10 years) implanted with a dual defibrillator were enrolled in the study; 66% had documented atrial fibrillation (AF) before implantation a nd 14% had no history of prior ventricular tachyarrhythmias.