Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Endowed Professor
Language English
Title Impact of Rapid Ventricular Tachycardia Stability on the Effectiveness of Antitachycardia Pacing Therapy before Defibrillation
Conference The 81st Annual Scientific Meeting of the Japanese Circulation Society (JCS2017)
Promoters Japanese Circulation Society
Conference Type Nationwide Conferences
Presentation Type Speech
Lecture Type General
Publisher and common publisher◎YAGISHITA Daigo, SHODA Morio, EJIMA Koichiro, IWANAMI Yuji, HENMI Ryuta, HAGIWARA Nobuhisa
Date 2017/03/17
(city and name of the country)
Kanazawa, JAPAN
Society abstract PROGRAM JCS 2017 208
Summary Background: Antitachycardia pacing before defibrillation (ATP-BD) could potentially terminate fast ventricular tachycardia (FVT) detected in ventricular fibrillation zone (VFZ) in patients implanted with ICD or CRTD. Tachycardia cycle length (TCL) has been reported as a predictor of successful FVT termination by ATP-BD, however, the tachycardia stability has not been well investigated.
Methods: This study consisted of 212 patients implanted with Biotronik ICD/CRTD since May 2008 until July 2016 in our institution. A total of 212 appropriate VFZ episodes was recorded in 31 patients. Thirty-three ATP-BD episodes in 11 patients with structural heart disease were investigated. Tachycardia stability (TS) was automatically calculated as a maximum time difference between the TCL among the last four beats before ATP-BD as well as the average of TCL.
Results: Eighteen successful termination episodes (54.5%) were observed among 33 ATP-BD episodes. The TCL was significantly longer and the TS was significantly smaller in successful episodes than unsuccessful episodes (292.2±17.8ms vs. 259.9±32.9ms, p<0.01, 9.7±6.2ms vs. 14.5±7.0ms, p<0.05, respectively). The percentage of TS in the TCL (TS) was also significantly smaller in successful episodes (3.3±2.2% vs.5.7±2.7%, p<0.01). The predictive cut-off value in TCL was 270ms (sensitivity=83.3%, specificity=60.0%, p<0.01, AUC=0.83), and %TS was 3.6% (sensitivity=77.8%, specificity=60.0%, p<0.05, AUC=0.73).
Conclusion: TCL and TS could be the important factors for successful FVT termination by ATP-BD in patients
with an ICD/CRTD.