Anti-tachycardia Pacing: Mechanism, History and Contemporary Implementation

Purpose of Review Implantable cardioverter-defibrillator (ICD) shocks, whether appropriate or inappropriate, are associated with significant morbidity and mortality. Anti-tachycardia pacing (ATP) is a painless treatment for reentrant ventricular tachycardia (VT), and it has been shown to be effective for treating fast VT with low risk of acceleration or syncope. Yet there is substantial difference in the frequency, rate, and mechanism of VT in ICD recipients implanted for primary versus secondary prevention indications and the benefit of ATP differs accordingly. We review the mechanism of ATP, the history of ATP through important clinical trials, and contemporary consideration of its therapeutic value. Recent Findings VT episodes are significantly more likely to spontaneously terminate in primary prevention patients. The value of ATP is overestimated, particularly in patients with primary prevention ICD indications. Summary Over the past 30 years, advances in technologies coupled with our understanding of appropriate ICD programming have drawn into question the value of empiric programming of ATP in primary prevention cohorts. Relatively long ICD therapy delays are safe and significantly reduce unnecessary ATP interventions in primary and secondary prevention cohorts. The mortality benefit of ICDs in most primary prevention patients may be derived from shock therapy alone..

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:24

Enthalten in:

Current treatment options in cardiovascular medicine - 24(2022), 3 vom: 01. März, Seite 27-40

Sprache:

Englisch

Beteiligte Personen:

Panchangam, Subhasree [VerfasserIn]
Monahan, Kevin M. [VerfasserIn]
Helm, Robert H. [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

BKL:

44.85$jKardiologie$jAngiologie

Themen:

Anti-tachycardia pacing
ICD therapy
Primary prevention of sudden death
Ventricular tachycardia

Anmerkungen:

© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022

doi:

10.1007/s11936-022-00959-0

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2129940617

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