P2883VT/VF treatment in a contemporary population of single chamber ICD recipients: ATP efficacVF

• Published in: European heart journal 2019-10, Vol.40 (Supplement_1)
• Main Authors: Angeletti, A, Paolisso, P, Statuto, G, Massaro, G, Lorenzetti, S, Frisoni, J, Martignani, C, Ziacchi, M, Giacopelli, D, Grassini, D, Diemberger, I, Biffi, M
• Format: Article
• Language: English
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehz748.1191

Abstract Aim of the study to investigate the efficacy of ATP in consecutive, unselected ICD recipients implanted in 2014–2015. Methods All patients had a VT zone as 350 ms and a VF zone as 280 ms programmed, with a detection duration >20 seconds and >8 seconds respectively for VT and VF. Anti-tachycardia pacing (ATP) was available before/during charging in the VF zone, while at least 3 attempts with ATP were programmed in the VT zone. ATP efficacy was assed at the first ventricular arrhythmia episode for each patient. Overall ATP efficacy was also calculated on the burden of treated episodes. Results A total of 165 patients (median age 63 [48–72] years, male 79%, primary prevention 80%, ischemic 53%) implanted with a single chamber ICD were followed for a median period of 847 [666–1030] days: 44 (27%) had VT/VF episodes. Among a total of 706 VT/VF episodes, 623 were treated with ATP and/or shock. 7 patients were treated with shock as first delivered therapy (efficacy 100%), whereas 33 were treated with ATP (efficacy 55% of treated patients, 71% of episodes). The median cycle of the treated arrhythmias was 309 [280–324] ms. Efficacy at first attempt ALL Ischemic NICM Primary Secondary Per patient (first therapy occurrence)   Shock (7/7) 100% (7/7) 100% – (6/6) 100% (1/1) 100%   ATP (18/33) 55% (13/23) 57% (5/10) 50% (13/22) 59% (5/11) 45% Per episode   Shock (14/14) 100% (14/14) 100% – (6/6) 59% (8/8) 100%   ATP (432/609) 71% (245/362) 68% (187/247) 76% (127/201) 63% (305/408) 75% Conclusion ATP is quite effective is a contemporary cohort of single chamber ICD recipients in a fast arrhythmia range (average 190–220 bpm) with a long detection. This observation strengthen the value of ATP in ICD selection, and should be balancen when considering an S-ICD.