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Antitachycardia Pacing for Rapid VT During ICD Charging: A Method to Prevent ICD Shocks
- Source :
- Pacing and Clinical Electrophysiology. 24:345-351
- Publication Year :
- 2001
- Publisher :
- Wiley, 2001.
-
Abstract
- WEBER, M., et al.: Antitachycardia Pacing for Rapid VT During ICD Charging: A Method to Prevent ICD Shocks. In patients with ICDs, rapid VTs are usually treated with shocks. It is unknown, if antitachycardia pacing (ATP) delivered once for rapid VT during capacitor charging can avoid painful shocks without increasing the risk of syncope. In patients in whom rapid monomorphic VT (cycle length 300–220 ms) could be reproducibly induced during predischarge ICD testing, the success of cardioversion (defibrillation threshold plus 10 J) and a single ATP attempt (burst with 8 or 16 stimuli) was compared using a randomized crossover study design. Consciousness of the patients was checked by the signal from a button constantly pushed by the patient. In 20 patients (ejection fraction 0.50 ± 0.19) rapid VTs (253 ± 26 ms) were reproducibly induced. A single burst successfully terminated 11 (55%) of 20 rapid VTs, 6 episodes could not be terminated with a single burst pacing and 3 VTs accelerated. Rapid VTs not terminated by ATP were significantly faster than those that could be terminated (246 vs 258 ms, P = 0.026). Cardioversion (19 ± 3 J) terminated the VTs in all cases. No patient suffered syncope during rapid VTs. A single ATP may terminate rapid VT with cycle lengths < 300 ms in 55% of patients without increasing the risk of syncope. Therefore, in rapid VTs one attempt of ATP may be suitable as an additional therapy option during ICD capacitor charging to avoid painful shocks without compromise of safety. Thus, future ICDs should implement the option of ATP during charging of capacitors.
- Subjects :
- Adult
Male
Pacemaker, Artificial
medicine.medical_specialty
medicine.medical_treatment
Cardioversion
Statistics, Nonparametric
Defibrillation threshold
Internal medicine
medicine
Humans
In patient
Cycle length
Aged
Chi-Square Distribution
Cross-Over Studies
Ejection fraction
business.industry
Cardiac Pacing, Artificial
General Medicine
Middle Aged
Implantable cardioverter-defibrillator
Electric Injuries
Tachycardia, Ventricular
Antitachycardia Pacing
Cardiology
Female
Icd shocks
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15408159 and 01478389
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Pacing and Clinical Electrophysiology
- Accession number :
- edsair.doi.dedup.....252dd518d97405b582a40da9d734e3ca