| Autor: |
Fries, Roland, Heisel, Armin, Kalweit, Gerhard, Jung, Jens, Schieffer, Hermann |
| Předmět: |
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| Zdroj: |
Pacing & Clinical Electrophysiology; Jan1997, Vol. 20 Issue 1, p198-202, 5p |
| Abstrakt: |
The purpose of this study was to determine the termination and acceleration rates for 1 to 6 attempts of antitachycardia pacing (ATP) delivered by ICD in order to terminate spontaneously occurring VTs. Twenty-four ICD recipients with active ATP programs, including a maximum of six ATP sequences and spontaneously occurring VTs during follow-up, were investigated. During a mean follow-up of 42 ± 15 months (range, 17-63 months) 413 spontaneous VT episodes (17 ± 14; range, 1-49 per patient) resulting in appropriate ATP delivery by the ICD occurred. ATP successfully terminated 328 episodes (80 %) with a mean number of 1.6 ± 1.1 pacing sequences. Eighty episodes (19%) were accelerated by ATP and 5 (1 %) were unresponsive to ATP. The ATP success decreased until the third ATP sequence (59% → 31% → 24%), but increased again in the fourth to sixth attempt (46% → 46% → 29%). The acceleration rate increased from sequence one to sequence three (8% → 13% → 28%), but decreased significantly in further ATP attempts (19% → 0% → 0%). The mean time delays until redetection or termination after 4, 5, and 6 attempts of ATP were 22 ± 5 seconds, 37 ± 2 seconds, and 41 ± 9 seconds, respectively. Nine patients (37%) used ⩾3 ATP attempts during follow-up and all of them had a therapeutic benefit from it. Five out of 13 VTs (38%) treated with s 4 attempts could ultimately be terminated by ATP. The results of this study demonstrate that the first ATP sequence is the most effective and that ⩾ 4 ATP attempts may be useful in a minority of patients. There seems to be a low risk of VT acceleration by the fourth to sixth ATP sequence. Because of the associated time delay, a high number of ATP attempts should only be programmed in patients with hemodynamically well-tolerated stable VTs. [ABSTRACT FROM AUTHOR] |
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