EFFICACY OF ANTI-TACHYCARDIA PACING IN THE TREATMENT OF VENTRICULAR ARRHYTHMIAS IN THE RAFT TRIAL

Abstract

BackgroundAnti-tachycardia pacing (ATP) is a common initial treatment in the termination of ventricular arrhythmias in implantable cardioverter defibrillators (ICDs). We sought to assess the efficacy of burst and ramp ATP on ventricular arrhythmias at different tachycardia cycle lengths (TCL) in the RAFT trial.MethodsThe RAFT trial randomized patients with functional class II and III heart failure to ICDs ± cardiac resynchronization and had standardized programming; VT was treated with burst pacing (8 beats/ 88% TCL/ fixed rate), followed by ramp pacing (6 beats/88% TCL/10ms decrements) if burst pacing failed. All arrhythmia events were adjudicated.ResultsView Large Image Figure ViewerDownload (PPT)ConclusionIn the cohort of RAFT patients it appears that ATP therapy was most successful in treating VT between 150-200bpm. VT faster than 200bpm was more likely to accelerate after ATP therapy, however, they too were more likely to receive Ramp ATP. BackgroundAnti-tachycardia pacing (ATP) is a common initial treatment in the termination of ventricular arrhythmias in implantable cardioverter defibrillators (ICDs). We sought to assess the efficacy of burst and ramp ATP on ventricular arrhythmias at different tachycardia cycle lengths (TCL) in the RAFT trial. Anti-tachycardia pacing (ATP) is a common initial treatment in the termination of ventricular arrhythmias in implantable cardioverter defibrillators (ICDs). We sought to assess the efficacy of burst and ramp ATP on ventricular arrhythmias at different tachycardia cycle lengths (TCL) in the RAFT trial. MethodsThe RAFT trial randomized patients with functional class II and III heart failure to ICDs ± cardiac resynchronization and had standardized programming; VT was treated with burst pacing (8 beats/ 88% TCL/ fixed rate), followed by ramp pacing (6 beats/88% TCL/10ms decrements) if burst pacing failed. All arrhythmia events were adjudicated. The RAFT trial randomized patients with functional class II and III heart failure to ICDs ± cardiac resynchronization and had standardized programming; VT was treated with burst pacing (8 beats/ 88% TCL/ fixed rate), followed by ramp pacing (6 beats/88% TCL/10ms decrements) if burst pacing failed. All arrhythmia events were adjudicated. Results ConclusionIn the cohort of RAFT patients it appears that ATP therapy was most successful in treating VT between 150-200bpm. VT faster than 200bpm was more likely to accelerate after ATP therapy, however, they too were more likely to receive Ramp ATP. In the cohort of RAFT patients it appears that ATP therapy was most successful in treating VT between 150-200bpm. VT faster than 200bpm was more likely to accelerate after ATP therapy, however, they too were more likely to receive Ramp ATP.