Arrhythmic episodes in patients implanted with a cardioverter-defibrillator - results from the Prospective Study on Predictive Quality with Preferencing PainFree ATP therapies (4P).

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_E5BA1D17D845
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Arrhythmic episodes in patients implanted with a cardioverter-defibrillator - results from the Prospective Study on Predictive Quality with Preferencing PainFree ATP therapies (4P).
Journal
BMC cardiovascular disorders
Author(s)
Regoli F., Graf D., Schaer B., Duru F., Ammann P., Stefano LMDS, Naegli B., Burri H., Zbinden R., Krasniqi N., Fromer M.
Working group(s)
4P Study Group
Contributor(s)
Moccetti T., Steffel A., Steffel J., Eriksson U.
ISSN
1471-2261 (Electronic)
ISSN-L
1471-2261
Publication state
Published
Issued date
17/06/2019
Peer-reviewed
Oui
Volume
19
Number
1
Pages
146
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Little is known about the ICD performance using enhanced detection algorithms in unselected, non-trial patients. Performance of recent generation ICD equipped with SmartShock™ technology (SST) for detection and conversion of ventricular tachyarrhythmias (VTA) was investigated.
4P was a prospective, multicenter, observational study conducted in 10 Swiss implanting centers. Patients with a Class I indication according to international guidelines were included and received an ICD with SST. ICD discrimination capability was assessed by evaluating SST performance; therapy efficacy was assessed by rate of VTA conversions by ATP and by rescue shocks.
Overall, 196 patients were included in the analysis with a mean duration of follow-up of 27.7 months (452 patient-years of observation). Patient-specific rather than recommended programming was preferred. Device-detected episodes were frequent (5147 episodes in 146 patients, 74.5%). In 44 patients (22.4%), 1274 episodes were categorized as VTA; only 215 episodes were symptomatic. ATP was the first-line therapy and highly effective (99.9% success rate at the episode level, 100.0% at the patient level). Rescue shocks were rare (66 episodes in 28 patients); 7 shocks in 5 patients (2.6%) were inappropriate. Death and hospitalization rates were low.
In a cohort of non-trial, unselected ICD patients, VTA episodes were frequent. The 4P results confirm the robustness of VTA detection by SST and the effectiveness of ATP treatment, hence limiting overall ICD shock burden.
Keywords
Aged, Death, Sudden, Cardiac/prevention & control, Defibrillators, Implantable, Electric Countershock/adverse effects, Electric Countershock/instrumentation, Electric Countershock/mortality, Female, Heart Rate, Hospitalization, Humans, Male, Middle Aged, Progression-Free Survival, Prospective Studies, Prosthesis Design, Prosthesis Failure, Risk Factors, Switzerland, Tachycardia, Ventricular/diagnosis, Tachycardia, Ventricular/mortality, Tachycardia, Ventricular/physiopathology, Tachycardia, Ventricular/therapy, Time Factors, Ventricular Fibrillation/diagnosis, Ventricular Fibrillation/mortality, Ventricular Fibrillation/physiopathology, Ventricular Fibrillation/therapy, Antitachycardia pacing, Implantable cardioverter-defibrillator, Shock, Ventricular tachyarrhythmia
Pubmed
Web of science
Open Access
Yes
Create date
01/08/2019 9:04
Last modification date
15/01/2021 7:12
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