PMID: 11310304Apr 20, 2001Paper

Antitachycardia pacing for rapid VT during ICD charging: a method to prevent ICD shocks

Pacing and Clinical Electrophysiology : PACE
M WeberD Böcker

Abstract

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. Th...Continue Reading

Citations

Mar 23, 2002·Forensic Science International : Synergy·Mirko JungeKlaus Püschel
Oct 6, 2004·Pacing and Clinical Electrophysiology : PACE·Michael O Sweeney
Nov 15, 2006·Pacing and Clinical Electrophysiology : PACE·John F MacGregorMohamed H Hamdan

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