Incidence and clinical relevance of slow ventricular tachycardia in Implantable cardioverter-defibrillator recipients - An international multicenter prospective study

Article

关键词: RHYTHM DISCRIMINATION;    DETECTION ALGORITHM;    PERFORMANCE;    GUIDELINES;    STABILITY;    EFFICACY;    CRITERIA;    SAFETY;   

DOI  :  10.1161/CIRCULATIONAHA.105.533513

来源: SCIE

【 摘 要 】

Background - This study aims to assess the incidence and clinical relevance of slow ventricular tachycardia (VT) and the effectiveness and/or deleterious effects of antitachycardia pacing in slow VT in implantable cardioverter-defibrillator recipients. Methods and Results - This multicenter prospective randomized study included 374 patients ( 326 men) without prior history of slow VT (< 148 bpm) implanted with a dual-chamber implantable cardioverter-defibrillator. Patients had a 3-zone detection configuration: a slow VT zone ( 101 to 148 bpm), a conventional VT zone (> 148 bpm), and a ventricular fibrillation zone. Patients were randomized to a treatment group (n = 183) with therapy activated in the slow VT zone or a monitoring group (n = 191) with no therapy in the slow VT zone. During follow-up ( 11 months), 449 slow VTs occurred in 114 patients (30.5% slow VT incidence); 181 VTs ( 54 patients) occurred in the monitoring group; 3 were readmitted to the hospital; and lightheadedness and palpitations occurred in 4 and 250 ( 60 patients) in the treatment group treated by antitachycardia pacing (89.8% success rate) and shock delivery (n = 2). There were 10 crossovers from the monitoring to treatment group and 3 crossovers from the treatment to monitoring group (P = 0.09). Quality of life scores were not different between groups. Conclusions - Slow VT incidence (< 150 bpm) is high (30%) in implantable cardioverter-defibrillator recipients without prior history of slow VT, has limited clinical relevance, and is efficiently and safely terminated by antitachycardia pacing.

【 授权许可】

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