The efficacy and safety of intrinsic antitachycardia pacing

Background

The clinical outcomes of a novel antitachycardia pacing (ATP) algorithm—intrinsic ATP (iATP)—compared to conventional ATP (cATP) have yet to be fully elucidated.

Methods

This retrospective study analyzed 128 patients and 1962 ventricular tachycardia (VT) episodes treated with the iATP or the cATP at Kokura Memorial Hospital. Patients were categorized into two groups: the iATP group (23 patients, 182 episodes) and the cATP group (105 patients, 1780 episodes). We evaluated ATP success rates and baseline patient characteristics on a per-patient basis. Additionally, we extracted VT that were not terminated by a single ATP and compared ATP success rates using propensity score matching.

Results

Per patient; The iATP group exhibited significantly lower creatinine levels (1.18 ± 0.40 mg/dL vs. 1.82 ± 1.61 mg/dL, p = .021) and a shorter follow-up period (609 ± 323 days vs. 1017 ± 252 days, p < .001) compared to the cATP group. ATP success was observed in 19 patients in the iATP group and 62 patients in the cATP group (82.6% vs. 59%, p = .054). Per episode; there was no significant difference in ATP success rate (91.8% vs. 92.7%, p = .645) or in acceleration rate (1.1% vs. 2.4%, p = .274). However, when limited to episodes in which VT was not terminated by a single ATP and propensity score matching was performed, the iATP showed a higher VT termination rate (84.1% vs. 53.6%, p < .001) and a lower acceleration rate (0% vs. 10.1%, p = .013) than the cATP.

Conclusions

The efficacy and safety of the iATP for VT that was not terminated by the first sequence of ATP was demonstrated.