Programming Antitachycardia Pacing for Primary Prevention in Patients With Implantable Cardioverter Defibrillators: Results From the PROVE Trial
- 6 December 2010
- journal article
- clinical trial
- Published by Wiley in Journal of Cardiovascular Electrophysiology
- Vol. 21 (12), 1349-1354
- https://doi.org/10.1111/j.1540-8167.2010.01825.x
Abstract
The PROVE trial was designed to determine if antitachycardia pacing (ATP) is clinically beneficial for primary prevention in patients who have implantable cardioverter defibrillators (ICDs) or cardiac resynchronization therapy defibrillators (CRT-Ds). use of ICDs and CRT-Ds reduces mortality in patients with ventricular dysfunction and mild to moderate heart failure. However, in studies of the primary prevention population, shock-only ICDs are predominantly used, without ATP programming for less painful termination of ventricular tachycardia (VT). we conducted a prospective, nonrandomized, multicenter study using market-released ICDs and CRT-Ds. Patients received devices programmed to deliver ATP for VT cycle lengths of 270-330 ms. Follow-up evaluation was performed at 3, 6, and 12 months. The incidence of VT and the rate of successful termination by ATP were analyzed. of 830 patients in the study population (men, 73%; mean age, 67.3 ± 12 years), 32% received single-chamber ICDs, 44% dual-chamber ICDs, and 24% CRT-Ds. ATP was attempted for 112 VT episodes in 71 patients, and 103 (92%) of the VT episodes were successfully terminated. Three VT episodes were accelerated by ATP and required termination by ICD shock; 6 episodes terminated spontaneously or by ICD shock. VT is common in patients without a history of this arrhythmia who have received ICDs or CRT-Ds for primary prevention indications. Programming ICDs for ATP therapy at the time of implantation could potentially terminate most VT episodes and reduce the number of painful shocks for these patients.Keywords
This publication has 21 references indexed in Scilit:
- VF and Fatal Cardiac Arrest Following ICD Therapy Delivery: What is the Cause?Pacing and Clinical Electrophysiology, 2007
- Sudden Cardiac DeathCirculation, 2006
- A Comparison of Empiric to Physician-Tailored Programming of Implantable Cardioverter-DefibrillatorsJournal of the American College of Cardiology, 2006
- Antitachycardia Pacing for Ventricular Tachycardia Using Implantable Cardioverter Defibrillators:Pacing and Clinical Electrophysiology, 2004
- Differences in Tachyarrhythmia Detection and Implantable Cardioverter Defibrillator Therapy by Primary or Secondary Prevention Indication in Cardiac Resynchronization Therapy PatientsJournal of Cardiovascular Electrophysiology, 2004
- Prophylactic Implantation of a Defibrillator in Patients with Myocardial Infarction and Reduced Ejection FractionNew England Journal of Medicine, 2002
- Termination and Acceleration of Ventricular Tachycardia with Autodecremental Pacing, Burst Pacing, and Cardioversion in Patients with an Implantable Cardioverter DefibrillatorPacing and Clinical Electrophysiology, 1995
- A prospective randomized comparison of autodecremental pacing to burst pacing in device therapy for chronic ventricular tachycardia secondary to coronary artery diseaseThe American Journal of Cardiology, 1993
- Randomized Cross‐Over Evaluation of Two Adaptive Pacing Algorithms for the Termination of Ventricular TachycardiaPacing and Clinical Electrophysiology, 1993
- Randomized controlled comparison of antitachycardia pacing algorithms for termination of ventricular tachycardiaJournal of the American College of Cardiology, 1993