Efficacy of Antitachycardia Pacing in Patients Presenting with Cardiac Arrest

RAMAN L. MITRA, HENRY H. HSIA, BRUCE G. HOOK, DAVID J. CALLANS, BELINDA T. FLORES, JOHN M. MILLER, MARK E. JOSEPHSON, FRANCIS E. MARCHLINSKI

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

The efficacy of antitachycardia pacing (ATP) incorporated into implantable cardioverter defibrillators (ICDs) was assessed in 29 consecutive survivors of cardiac arrest, not attributable to acute myocardial infarction, ischemia, or drug and electrolyte effects. The cohort included 25 men and 4 women with a mean age of 65 years and a mean left ventricular ejection fraction of 29%. Seventeen patients had coronary artery disease, 11 had nonischemic dilated cardiomyopathy, and 1 had long QT syndrome. Programmed stimulation yielded monomorphic ventricular tachycardia (VT) in 17 patients, polymorphic VT in 6, and no inducible VT in 6. During a mean follow‐up of 22 months, a total of 91 episodes of monomorphic VT occurred, 73 of which were successfully pace terminated (83%). Monomorphic VT amenable to pace termination recurred only in the group that had this arrhythmia inducible. The recurrent arrhythmias in the 12 patients having either no inducible VT or polymorphic VT were all rapid VTs, having a cycle length < 220 ms; and therefore, not amenable to pace termination. These results suggest that ATP incorporated into ICDs is useful in survivors of cardiac arrest and may significantly reduce the number of shocks that these patients would otherwise receive. Programmed stimulation may also help to define those patients who would receive the maximum benefit from ATP.

Original languageEnglish (US)
Pages (from-to)2035-2040
Number of pages6
JournalPacing and Clinical Electrophysiology
Volume18
Issue number11
DOIs
StatePublished - Nov 1995
Externally publishedYes

Keywords

  • antitachycardia pacing
  • cardiac arrest
  • implantable cardioverter defibrillator
  • ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    MITRA, RAMAN. L., HSIA, HENRY. H., HOOK, BRUCE. G., CALLANS, DAVID. J., FLORES, BELINDA. T., MILLER, JOHN. M., JOSEPHSON, MARK. E., & MARCHLINSKI, FRANCIS. E. (1995). Efficacy of Antitachycardia Pacing in Patients Presenting with Cardiac Arrest. Pacing and Clinical Electrophysiology, 18(11), 2035-2040. https://doi.org/10.1111/j.1540-8159.1995.tb03865.x