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Tsukahara K, Oginosawa Y, Fujino Y, Honda T, Kikuchi K, Nozoe M, Uchida T, Minamiguchi H, Sonoda K, Ogawa M, Ideguchi T, Kizaki Y, Nakamura T, Oba K, Higa S, Yoshida K, Yagyu K, Miyamoto T, Yamagishi Y, Ohe H, Kohno R, Kataoka M, Otsuji Y, Abe H. RR interval variability in the evaluation of ventricular tachycardia and effects of implantable cardioverter defibrillator therapy. J Arrhythm 2021; 37:1052-1060. [PMID: 34386132 PMCID: PMC8339111 DOI: 10.1002/joa3.12551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/13/2021] [Accepted: 04/21/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND An implantable cardioverter defibrillator (ICD) is the most reliable therapeutic device for preventing sudden cardiac death in patients with sustained ventricular tachycardia (VT). Regarding its effectiveness, targeted VT is defined based on the tachyarrhythmia cycle length. However, variations in RR interval variability of VTs may occur. Few studies have reported on VT characteristics and effects of ICD therapy according to the RR interval variability. We aimed to identify the clinical characteristics of VTs and ICD therapy effects according to the RR interval variability. METHODS We analyzed 821 VT episodes in 69 patients with ICDs or cardiac resynchronization therapy defibrillators. VTs were classified as irregular when the difference between two successive beats was >20 ms in at least one of 10 RR intervals; otherwise, they were classified as regular. We evaluated successful termination using anti-tachycardia pacing (ATP)/shock therapy, spontaneous termination, and acceleration between regular and irregular VTs. The RR interval variability reproducibility rates were evaluated. RESULTS Regular VT was significantly more successfully terminated than irregular VT by ATP. No significant difference was found in shock therapy or VT acceleration between the regular and irregular VTs. Spontaneous termination occurred significantly more often in irregular than in regular VT cases. The reproducibility rates of RR interval variability in each episode and in all episodes were 89% and 73%, respectively. CONCLUSIONS ATP therapy showed greater effectiveness for regular than for irregular VT. Spontaneous termination was more common in irregular than in regular VT. RR interval variability of VTs seems to be reproducible.
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Affiliation(s)
- Keita Tsukahara
- The Second Department of Internal MedicineUniversity of Occupational and Environment HealthKitakyushuJapan
| | - Yasushi Oginosawa
- The Second Department of Internal MedicineUniversity of Occupational and Environment HealthKitakyushuJapan
| | - Yoshihisa Fujino
- The Department of Environmental Epidemiology Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Toshihiro Honda
- Division of CardiologyKumamoto Junkankika HospitalKumamotoJapan
| | - Kan Kikuchi
- Division of CardiologyJapan Community Healthcare OrganizationKyushu HospitalKitakyusyuJapan
| | - Masatsugu Nozoe
- Division of CardiologySaiseikai Fukuoka General HospitalFukuokaJapan
| | - Takayuki Uchida
- Department of Cardiovascular SurgeryIizuka HospitalIizukaJapan
| | | | - Koichiro Sonoda
- Department of CardiologySasebo City General HospitalSaseboJapan
| | - Masahiro Ogawa
- Department of CardiologyFukuoka University School of MedicineFukuokaJapan
| | - Takeshi Ideguchi
- Department of Internal Medicine, Circulatory and Body Fluid RegulationFaculty of MedicineUniversity of MiyazakiMiyazakiJapan
| | | | - Toshihiro Nakamura
- Department of CardiologyNational Hospital Organization Kyushu Medical CenterFukuokaJapan
| | - Kageyuki Oba
- Department of CardiologyYuai Medical CenterOkinawaJapan
| | - Satoshi Higa
- Cardiac Electrophysiology and Pacing LaboratoryDivision of Cardiovascular MedicineMakiminato Central HospitalOkinawaJapan
| | - Keiki Yoshida
- Department of CardiologySaga‐ken Medical Centre KoseikanSagaJapan
| | - Keishiro Yagyu
- The Second Department of Internal MedicineUniversity of Occupational and Environment HealthKitakyushuJapan
| | - Taro Miyamoto
- The Second Department of Internal MedicineUniversity of Occupational and Environment HealthKitakyushuJapan
| | - Yasunobu Yamagishi
- The Second Department of Internal MedicineUniversity of Occupational and Environment HealthKitakyushuJapan
| | - Hisaharu Ohe
- The Second Department of Internal MedicineUniversity of Occupational and Environment HealthKitakyushuJapan
| | - Ritsuko Kohno
- Department of Heart Rhythm ManagementUniversity of Occupational and Environment HealthKitakyusyuJapan
| | - Masaharu Kataoka
- The Second Department of Internal MedicineUniversity of Occupational and Environment HealthKitakyushuJapan
| | - Yutaka Otsuji
- The Second Department of Internal MedicineUniversity of Occupational and Environment HealthKitakyushuJapan
| | - Haruhiko Abe
- Department of Heart Rhythm ManagementUniversity of Occupational and Environment HealthKitakyusyuJapan
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Cycle length of nonsustanied ventricular tachycardias among ICD patients: implications on subsequent appropriate therapies. BMC Cardiovasc Disord 2021; 21:268. [PMID: 34058991 PMCID: PMC8167949 DOI: 10.1186/s12872-021-02087-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 05/26/2021] [Indexed: 11/12/2022] Open
Abstract
Background ICD patients with episodes of nonsustained ventricular tachycardias (NSVT) are at risk of appropriate therapies. However, the relationship between the cycle length (CL) of such NSVTs and the subsequent incidence of appropriate interventions is unknown. Methods 416 ICD patients with LVEF < 45% were studied. ICD programming was standardized. NSVT was defined as any VT of 5 or more beats at ≥ 150 bpm occurred in the first 6 months after implantation that terminated spontaneously and was not preceded by any appropriate therapy. The mean follow-up was 41 ± 27 months. Results We analyzed 2201 NSVTs (mean CL = 323 ms) that occurred in 250 patients; 111 of such episodes were fast (CL ≤ 300 ms). Secondary prevention (HR = 1.7; p < 0.001), number of NSVT episodes (HR = 1.05; 95% CI 1.04–1.07; p < 0.001) and beta-blocker treatment (HR = 0.7; p = 0.04) were independent predictors of appropriate interventions; however, the mean CL of NSVTs was not (p = 0.6). There was a correlation between the mean CL of NSVTs and the CL of the first monomorphic VT: r = 0.88; p < 0.001. This correlation was especially robust in individuals with > 5 NSVTs (r = 0.97; p < 0.001), with an agreement between both values greater than 95%. Patients with any fast NSVT experienced a higher incidence of VF episodes (26%) compared to those without NVSTs (3%) or with only slow NSVTs (7%); p < 0.001. Conclusions Unlike the burden, the CL of NSVTs is not a predictor of subsequent appropriate interventions. However, there is a close relationship between the CL of NSVTs and that of arrhythmias that will later lead to appropriate therapies.
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Jiménez-Candil J, Durán O, Núñez J, Bravo L, Hernández J, Martín-García A, Morínigo J, Sánchez PL. Effectiveness of first versus successive antitachycardia pacing attempts: predictors and clinical consequences. J Interv Card Electrophysiol 2019; 56:349-357. [DOI: 10.1007/s10840-019-00624-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/06/2019] [Indexed: 11/30/2022]
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Quast AFBE, Brouwer TF, Tjong FVY, Wilde AAM, Knops RE. Clinical parameters to optimize patient selection for subcutaneous and transvenous implantable defibrillator therapy. Pacing Clin Electrophysiol 2018; 41:990-995. [PMID: 29897106 DOI: 10.1111/pace.13411] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 04/12/2018] [Accepted: 05/07/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND The subcutaneous implantable cardioverter-defibrillator (S-ICD) lacks the antitachycardia pacing (ATP) capability of tranvenous ICDs (TV-ICD). S-ICD patient selection can be challenging as some patients may benefit from ATP. We aim to identify clinical predictors of ATP benefit, in order to improve patient selection for S-ICD or TV-ICD therapy. METHODS De novo single- and dual-chamber TV-ICD patients implanted between March 2011 and December 2015 were included. Ventricular arrhythmias terminated by ATP and not followed by a shock were considered successful ATP therapy. Cox proportional hazard analysis was performed to assess the adjusted effect of multiple predictors for appropriate ATP and shock therapy. RESULTS Note that 431 patients were included with a median follow-up of 26 months. Ninety-nine patients (23%) received appropriate ATP therapy, which terminated the arrhythmia in 67%. A history of nonsustained ventricular tachycardia (NSVT) or monomorphic VT (MVT) was the only predictor of appropriate ATP therapy in the multivariable model (hazard ratio [HR] 2.73, P < 0.001). Sixty-five of 221 patients with a history of NS (VT) received appropriate ATP (29%) versus 24 patients (11%) without a history NS (VT) (P < 0.001). A secondary prevention indication was the only predictor in the multivariate model for appropriate shock therapy (HR 1.82, P = 0.05). CONCLUSION A history of NSVT or MVT is a significant predictor for appropriate and successful ATP therapy. One in three patients with NSVT or MVT received appropriate ATP versus one in 10 patients without a history of NSVT or MVT over a 2-year period of follow-up.
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Affiliation(s)
- Anne-Floor B E Quast
- Department of Clinical and Experimental Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Tom F Brouwer
- Department of Clinical and Experimental Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Fleur V Y Tjong
- Department of Clinical and Experimental Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Arthur A M Wilde
- Department of Clinical and Experimental Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Reinoud E Knops
- Department of Clinical and Experimental Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Fang Y, Gu K, Yang B, Ju W, Chen H, Li M, Liu H, Wang J, Yang G, Chen M. What factors lead to the acceleration of ventricular tachycardia during antitachycardia pacing?-Results from over 1000 episodes. J Arrhythm 2017; 34:36-45. [PMID: 29721112 PMCID: PMC5828264 DOI: 10.1002/joa3.12010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 10/04/2017] [Indexed: 11/25/2022] Open
Abstract
Introduction Ventricular tachycardia (VT) acceleration due to antitachycardia pacing (ATP) therapy could be often observed in patients with implantable cardioverter defibrillator (ICD), which usually results in additional shock. However, few studies focused on the risk factors for VT acceleration caused by ATP therapy. The purpose of this study was to investigate risk factors for VT acceleration due to ATP delivery. Methods We retrospectively reviewed 1056 ATP episodes in 33 patients with structural heart diseases, of whom clinical characteristics and episodes details were evaluated. Results At individual patient level, number of VT morphologies recorded in electrograms during follow‐up was a risk factor with cutoff point of 1 (AUC 0.79, sensitivity 72.7%, specificity 77.3%, P < .001) to predict ATP acceleration (OR 3.50, P = .008). From episode‐based analysis, VT cycle length (VTCL) and mean variation in VTCL were risk factors to predict ATP acceleration (OR 0.98, P < 0.001 vs OR 1.06, P < .001, respectively), with cutoff points of 347 ms (AUC 0.67, sensitivity 82.5%, specificity 47.6%, P < .001) and 7.3 ms (AUC 0.66, sensitivity 77.5%, specificity 56.7%, P < .001), respectively. In addition, VTs with cycle length less than 347 ms were more likely to be accelerated by burst stimulation with more pulse numbers (OR 3.31, P < .001). Conclusions Number of VT morphologies, VTCL, and mean variation in VTCL are risk factors predicting ATP acceleration. Burst stimulation with less pulse numbers should be performed in VTs with cycle length less than 347 ms.
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Affiliation(s)
- Yin Fang
- Department of Anesthesiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Kai Gu
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Bing Yang
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Weizhu Ju
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Hongwu Chen
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Mingfang Li
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Hailei Liu
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Jiaxian Wang
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Gang Yang
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Minglong Chen
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
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Arenal A, Proclemer A, Kloppe A, Lunati M, Martìnez Ferrer JB, Hersi A, Gulaj M, Wijffels MCEF, Santi E, Manotta L, Mangoni L, Gasparini M. Different impact of long-detection interval and anti-tachycardia pacing in reducing unnecessary shocks: data from the ADVANCE III trial. Europace 2016; 18:1719-1725. [PMID: 27485577 PMCID: PMC5408998 DOI: 10.1093/europace/euw032] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 02/02/2016] [Indexed: 11/14/2022] Open
Abstract
AIMS A long-detection interval (LDI) (30/40 intervals) has been proved to be superior to a standard-detection interval (SDI) (18/24 intervals) in terms of reducing unnecessary implantable cardioverter defibrillator (ICD) therapies. To better evaluate the different impact of LDI and anti-tachycardia pacing (ATP) on reducing painful shocks, we assessed all treated episodes in the ADVANCE III trial. METHODS AND RESULTS A total of 452 fast (200 ms < cycle length ≤ 320 ms) arrhythmic episodes were recorded: 284 in 138 patients in the SDI arm and 168 in 82 patients in the LDI arm (106/452 inappropriate detections). A total of 346 fast ventricular tachycardias (FVT) were detected in 169 patients: 208 in 105 patients with SDI and 138 in 64 patients with LDI. Setting LDI determined a significant reduction in appropriate but unnecessary therapies [208 in SDI vs. 138 in LDI; incidence rate ratio (IRR): 0.61 (95% CI 0.45-0.83), P = 0.002]. Anti-tachycardia pacing determined another 52% reduction in unnecessary shocks [208 in SDI with hypothetical shock-only programming vs. 66 in LDI with ATP; IRR: 0.37 (95% CI 0.25-0.53, P < 0.001)]. The efficacy of ATP in terminating FVT was 63% in SDI and 52% in LDI (P = 0.022). No difference in the safety profile (acceleration/degeneration and death/cardiovascular hospitalizations) was observed between the two groups. CONCLUSION The combination of LDI and ATP during charging is extremely effective and significantly reduces appropriate but unnecessary therapies. The use of LDI alone yielded a 39% reduction in appropriate but unnecessary therapies; ATP on top of LDI determined another 52% reduction in unnecessary shocks. The strategy of associating ATP and LDI could be considered in the majority of ICD recipients.
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Affiliation(s)
- Angel Arenal
- Hospital General Universitario Gregorio Marañón, C/Dr. Esquerdo 46, 28007 Madrid, Spain
| | - Alessandro Proclemer
- Azienda Ospedaliero Universitaria S. Maria della Misericordia, Piazzale S. Maria della Misericordia, 33100 Udine, Italy
| | - Axel Kloppe
- Medizinische Klinik II, Kardiologie und Angiologie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Ruhr-Universität-Bochum, Bochum, Germany
| | - Maurizio Lunati
- Azienda Ospedaliera Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3-20162 Milano, Italy
| | | | - Ahmad Hersi
- College of Medicine, King Saud University, 11472 Riyadh, Saudi Arabia
| | | | | | - Elisabetta Santi
- MEDTRONIC Clinical Research Center, Via Aurelia 475/477-00165, Roma, Italy
| | - Laura Manotta
- MEDTRONIC Clinical Research Center, Via Varesina, 162-20156 Milano, Italy
| | - Lorenza Mangoni
- MEDTRONIC Clinical Research Center, Via Aurelia 475/477-00165, Roma, Italy
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MATÍA ROBERTO, HERNÁNDEZ-MADRID ANTONIO, SÁNCHEZ-HUETE GONZALO, MARTÍNEZ-FERRER JOSÉBAUTISTA, ALZUETA JAVIER, VIÑOLAS XAVIER, RUBIO JERÓNIMO, PORRES JOSÉMANUEL, RODRÍGUEZ ANÍBAL, GARCÍA ENRIQUE, FERNÁNDEZ-LOZANO IGNACIO, ÁLVAREZ MIGUEL, MORENO JAVIER. An Automatic Algorithm Based on Morphological Stability During Fast Ventricular Arrhythmias Predicts Successful Antitachycardia Pacing in ICD Patients: A Multicenter Study. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2016; 39:633-41. [DOI: 10.1111/pace.12858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 03/13/2016] [Accepted: 03/20/2016] [Indexed: 11/27/2022]
Affiliation(s)
- ROBERTO MATÍA
- Arrhythmia Unit, Cardiology Department; Ramón y Cajal Hospital; Madrid Spain
| | | | | | | | | | | | | | | | | | | | | | - MIGUEL ÁLVAREZ
- Complejo Hospitalario Universitario de Granada; Granada Spain
| | - JAVIER MORENO
- Arrhythmia Unit, Cardiology Department; Ramón y Cajal Hospital; Madrid Spain
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Jiménez-Candil J, Hernández J, Martín A, Moríñigo J, Perdiguero P, Bravo L, Ruiz S, Sánchez PL. Differences in ventricular tachyarrythmias and antitachycardia pacing effectiveness according to the ICD indication (primary versus secondary prevention): an analysis based on the stored electrograms. J Interv Card Electrophysiol 2015; 44:187-95. [DOI: 10.1007/s10840-015-0050-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 08/14/2015] [Indexed: 12/22/2022]
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Cantillon DJ, Wilkoff BL. Antitachycardia pacing for reduction of implantable cardioverter-defibrillator shocks. Heart Rhythm 2015; 12:1370-5. [PMID: 25708880 DOI: 10.1016/j.hrthm.2015.02.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Indexed: 12/11/2022]
Abstract
Antitachycardia pacing (ATP) strategies represent safe, effective, and painless therapy for ventricular tachyarrhythmias, with a large body of clinical evidence supporting their routine use in both primary and secondary implantable cardioverter-defibrillator recipients. This article details the evidence supporting the use of standardized and validated ATP strategies for primary prevention patients and the conceptual framework to design effective ATP strategy for secondary prevention patients.
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Affiliation(s)
- Daniel J Cantillon
- Cleveland Clinic, Heart and Vascular Institute, Cardiac Electrophysiology and Pacing, Cleveland, Ohio.
| | - Bruce L Wilkoff
- Cleveland Clinic, Heart and Vascular Institute, Cardiac Electrophysiology and Pacing, Cleveland, Ohio
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10
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Feng XF, Sun J, Wang J, Li YG. Non-response to implantable cardioverter defibrillator in a post-infarction patient with recurrent ventricular tachycardia after catheter ablation. Chin Med J (Engl) 2015; 128:415-6. [PMID: 25635444 PMCID: PMC4837879 DOI: 10.4103/0366-6999.150122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | - Yi-Gang Li
- Department of Cardiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
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11
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Barbhaiya CR, Kumar S, Ng J, Nagashima K, Choi EK, Enriquez A, Chinitz J, Epstein LM, Tedrow UB, John RM, Stevenson WG, Michaud GF. Avoiding tachycardia alteration or termination during attempted entrainment mapping of atrial tachycardia related to atrial fibrillation ablation. Heart Rhythm 2015; 12:32-5. [DOI: 10.1016/j.hrthm.2014.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Indexed: 10/24/2022]
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12
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Jiménez-Candil J, Moríñigo JL, Hernández J, Martín A, Durán O, Carlos Rama J, Ledesma C, Sánchez PL. Fragmentation of the paced QRS complex: a marker of antitachycardia pacing effectiveness among ICD patients. J Cardiovasc Electrophysiol 2014; 25:1100-8. [PMID: 24816219 DOI: 10.1111/jce.12451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 04/25/2014] [Accepted: 05/02/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The presence of notches in the paced QRS complex (P-QRS) from the right ventricular apex (RVA) reflects delays in the activation of the left ventricle and may therefore be associated with longer times of stimulus conduction. Our objective was to determine prospectively the relationship between the duration of a notch ≥0.1 mV in the P-QRS (DN) and the effectiveness of antitachycardia pacing (ATP). METHODS AND RESULTS We followed 286 implantable cardioverter-defibrillator (ICD) patients with left ventricular dysfunction (pacing site: RVA) for 41 ± 27 months. ICD programming was standardized. P-QRS (100 bpm) was obtained at implant (50 mm/s). A total of 955 monomorphic ventricular tachycardias (VTs) with a cycle length of 335 ± 32 milliseconds occurred consecutively in 108 patients. ATP was successful in 84% of VTs. DN correlated with the probability of ineffective ATP (C = 0.67; P < 0.001), the cutoff point with the best sensitivity and specificity being 50 milliseconds. The adjusted mean ATP effectiveness per patient was 76% (95% CI: 72-85). Patients with a DN ≥ 50 milliseconds had a lower ATP efficiency: 67% (56-77) versus 92% (87-97) and a higher proportion of VTs terminated with shocks (SH): 31% (21-42) versus 8% (2-14); P < 0.001 for both. Although the occurrence of VT was similar (41% vs. 40%), the incidence of VT-related SH was higher in patients with a DN ≥ 50 (25% vs. 14%; P = 0.01) in the overall study population (n = 286). CONCLUSIONS When ATP is applied to the RVA, a DN ≥ 50 milliseconds is associated with a lower ATP effectiveness and a higher risk of SH due to VT.
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TUAN TACHUAN, LO MENTZUNG, LIN YENNJIANG, HSIEH WANHSIN, LIN CHEN, HUANG NORDENE, LO LIWEI, CHAO TZEFAN, LIAO JONAN, HSIEH YUCHENG, WU TSUJUEY, CHEN SHIHANN. The Use of Signal Analyses of Ventricular Tachycardia Electrograms to Predict the Response of Antitachycardia Pacing in Patients with Implantable Cardioverter-Defibrillators. J Cardiovasc Electrophysiol 2014; 25:411-417. [DOI: 10.1111/jce.12340] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/11/2013] [Accepted: 11/26/2013] [Indexed: 11/29/2022]
Affiliation(s)
- TA-CHUAN TUAN
- Division of Cardiology; Department of Medicine; Taipei Veterans General Hospital; Taipei Taiwan
- Faculty of Medicine and Institute of Clinical Medicine; National Yang-Ming University; School of Medicine; Taipei Taiwan
- Division of Cardiology, Taipei Municipal Gan-Dau Hospital; Taipei Taiwan
| | - MEN-TZUNG LO
- Research Center for Adaptive Data Analysis; Analysis and Center for Dynamical Biomarkers and Translational Medicine; National Central University; Jhongli Taiwan R.O.C
| | - YENN-JIANG LIN
- Division of Cardiology; Department of Medicine; Taipei Veterans General Hospital; Taipei Taiwan
- Faculty of Medicine and Institute of Clinical Medicine; National Yang-Ming University; School of Medicine; Taipei Taiwan
| | - WAN-HSIN HSIEH
- Research Center for Adaptive Data Analysis; Analysis and Center for Dynamical Biomarkers and Translational Medicine; National Central University; Jhongli Taiwan R.O.C
- Medical Biodynamics Program; Division of Sleep Medicine; Brigham and Women's Hospital; Harvard Medical School; Boston Massachusetts USA
| | - CHEN LIN
- Research Center for Adaptive Data Analysis; Analysis and Center for Dynamical Biomarkers and Translational Medicine; National Central University; Jhongli Taiwan R.O.C
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Palo Alto California USA
| | - NORDEN E. HUANG
- Research Center for Adaptive Data Analysis; Analysis and Center for Dynamical Biomarkers and Translational Medicine; National Central University; Jhongli Taiwan R.O.C
| | - LI-WEI LO
- Division of Cardiology; Department of Medicine; Taipei Veterans General Hospital; Taipei Taiwan
- Faculty of Medicine and Institute of Clinical Medicine; National Yang-Ming University; School of Medicine; Taipei Taiwan
| | - TZE-FAN CHAO
- Division of Cardiology; Department of Medicine; Taipei Veterans General Hospital; Taipei Taiwan
- Faculty of Medicine and Institute of Clinical Medicine; National Yang-Ming University; School of Medicine; Taipei Taiwan
| | - JO-NAN LIAO
- Division of Cardiology; Department of Medicine; Taipei Veterans General Hospital; Taipei Taiwan
- Faculty of Medicine and Institute of Clinical Medicine; National Yang-Ming University; School of Medicine; Taipei Taiwan
| | - YU-CHENG HSIEH
- Division of Cardiology; Department of Medicine; Taipei Veterans General Hospital; Taipei Taiwan
- Cardiovascular Center; Taichung Veterans General Hospital; Taichung Taiwan
| | - TSU-JUEY WU
- Division of Cardiology; Department of Medicine; Taipei Veterans General Hospital; Taipei Taiwan
- Cardiovascular Center; Taichung Veterans General Hospital; Taichung Taiwan
| | - SHIH-ANN CHEN
- Division of Cardiology; Department of Medicine; Taipei Veterans General Hospital; Taipei Taiwan
- Faculty of Medicine and Institute of Clinical Medicine; National Yang-Ming University; School of Medicine; Taipei Taiwan
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14
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JIMÉNEZ-CANDIL JAVIER, ANGUERA IGNASI, LEDESMA CLAUDIO, FERNÁNDEZ-PORTALES JAVIER, MORÍÑIGO JOSÉLUIS, DALLAGLIO PAOLO, MARTÍN ANA, CANO TERESA, HERNÁNDEZ JESÚS, SABATÉ XAVIER, MARTÍN-LUENGO CÁNDIDO. Morphology of Far-Field Electrograms and Antitachycardia Pacing Effectiveness Among Fast Ventricular Tachycardias Occurring in ICD Patients: A Multicenter Study. J Cardiovasc Electrophysiol 2013; 24:1375-82. [DOI: 10.1111/jce.12228] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 06/20/2013] [Accepted: 06/26/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | - IGNASI ANGUERA
- L'Hospitalet de Llobregat; Hospital Universitario de Bellvitge; Barcelona Spain
| | - CLAUDIO LEDESMA
- Cardiology Department; IBSAL-Hospital Universitario; Salamanca Spain
| | | | | | - PAOLO DALLAGLIO
- L'Hospitalet de Llobregat; Hospital Universitario de Bellvitge; Barcelona Spain
| | - ANA MARTÍN
- Cardiology Department; IBSAL-Hospital Universitario; Salamanca Spain
| | - TERESA CANO
- Cardiology Department; IBSAL-Hospital Universitario; Salamanca Spain
| | | | - XAVIER SABATÉ
- L'Hospitalet de Llobregat; Hospital Universitario de Bellvitge; Barcelona Spain
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