Prospective multicenter randomized trial of fast ventricular tachycardia termination by prolonged versus conventional anti-tachyarrhythmia burst pacing in implantable cardioverter-defibrillator patients-Atp DeliVery for pAiNless ICD thErapy (ADVANCE-D) Trial results

Purpose The purpose of the trial was to quantify and compare the efficacy of two different sequences of burst anti-tachycardia pacing (ATP) strategies for the termination of fast ventricular tachycardia. Methods The trial was prospective, multicenter, parallel and randomized, enrolling patients with...

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Bibliographic Details
Published in:Journal of interventional cardiac electrophysiology 2010-03, Vol.27 (2), p.127-135
Main Authors: Santini, Massimo, Lunati, Maurizio, Defaye, Pascal, Mermi, Johann, Proclemer, Alessandro, del Castillo-Arroys, Silvia, Molon, Giulio, Santi, Elisabetta, De Santo, Tiziana, Navarro, Xavier, Kloppe, Axel
Format: Article
Language:English
Subjects:
Cardiac Pacing, Artificial - mortality
Cardiology
Electric Countershock - mortality
Europe
Female
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Prevalence
Prospective Studies
Risk Assessment - methods
Risk Factors
Survival Analysis
Survival Rate
Tachycardia, Ventricular - mortality
Tachycardia, Ventricular - prevention & control
Treatment Outcome
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Summary:Purpose The purpose of the trial was to quantify and compare the efficacy of two different sequences of burst anti-tachycardia pacing (ATP) strategies for the termination of fast ventricular tachycardia. Methods The trial was prospective, multicenter, parallel and randomized, enrolling patients with an indication for implantable cardioverter-defibrillator implantation. Results From February 2004, 925 patients were randomized and followed-up for 12 months. Eight pulses ATP terminated 64% of episodes vs. 70% in the 15-pulse group ( p  = 0.504). Fifteen pulses proved significantly better in patients without a previous history of heart failure ( p  = 0.014) and in patients with LVEF ≥ 40% ( p  = 0.016). No significant differences between groups were observed with regard to syncope/near-syncope occurrence. Conclusion In the general population, 15-pulse ATP is as effective and safe as eight-pulse ATP. The efficacy of ATP on fast ventricular arrhythmias confirmed once more the striking importance of careful device programming in order to reduce painful shocks.
ISSN:1383-875X
1572-8595
DOI:10.1007/s10840-009-9454-z