Antitachycardia pacing to terminate ventricular tachyarrhythmia: new insights into how to reduce painful implantable cardioverter defibrillator shocks

Abstract

This editorial refers to ‘Safety and efficacy of programming a high number of antitachycardia pacing attempts for fast ventricular tachycardia: a prospective study’ by R.P. Martins et al ., on page 1457 and ‘First inappropriate implantable cardioverter defibrillator therapy is often due to inaccurate device programming: analysis of the French OPERA registry’ by A. Leenhardt et al ., on page 1465 The termination of life-threatening fast ventricular tachycradia (FVT) by the delivery of antitachycardia pacing (ATP) through the right ventricular implantable cardioverter defibrillator (ICD) lead was first investigated by Wathen et al .1 in a prospective randomized trial. They demonstrated that the ATP approach did not take longer than 6 s to stop FVT compared with conventional ICD shock delivery as the common type of therapy. One interesting finding in this study was that the fear of syncope or delay of the life-saving ICD shock was no longer justified since no difference between the two groups was detected. Over the following years, ATP has become a valuable option to treat all VT episodes. Large-scale studies, …