Table 4 Summary for previous studies addressing VT acceleration in response to anti-tachycardia pacing
From: Arrhythmogenicity of anti-tachycardia pacing in patients with implantable cardioverter defibrillator
Study | Study design | Studied VT episodes | VT acceleration % | Predictors of VT acceleration | ATP success rate | ATP failure rate | AAD | LV EF | Structural heart disease |
|---|---|---|---|---|---|---|---|---|---|
Fang et al. [15] | Retrospective study | Spontaneous VT & induced VT in EPS in in ICD patients | 3.7% | Number of VT morphologies in EGMs, VT induced by EPS, VTCL < 347 ms, mean variation in VTCL, burst stimulation with more pulse numbers | 81.43% | 14.7% | Not reported | Mean LV EF = 50.5% in the accelerated group; mean LV EF = 59.9% in the non-accelerated group | No relation found between the underlying structural heart disease and ATP success or failure |
The SATISFACTION study [19] | Prospective, randomized, multicenter trial | Spontaneous VT in ICD patients | 2.9% | Not reported | 61.7% Predictors of success: female sex, CAD, primary prevention, narrow QRS, FVT CL, ACEI/ARB and absence of β-blocker | 38.3% | Not reported | mean LV EF = 42.9 ± 17.2% | There was no difference between patients with CAD& non-CAD in VT acceleration by ATP |
ADVANCE-D Trial [10] | Prospective, parallel and randomized, multicenter trial | Spontaneous VT in ICD patients | 3.9% | Not reported | 67% Predictors of success: administration of ACEI and NYHA functional class | 33% | AAD therapy did not affect the response to ATP therapy | Mean LV EF = 33.9 ± 12.1% | Patients with CAD showed comparable response to ATP therapy as those with no CAD |
Pain Free Rx II [6] | Prospective, randomized, multicenter trial | Spontaneous VT in ICD patients | 2% in FVT (240–320 ms) | Not reported | 72% in FVT No clinical predictors of success were found. With every 5% increase in LV EF the odds of successful ATP for FVT are 18% higher | 28% in FVT | Not reported | Mean LVEF = 32 ± 13% | ATP success was 67% in patients with CAD and 83% in patients without CAD (P = 0.16) |
Pain free Rx I [8] | Prospective multicenter trial | Spontaneous VT in CAD patients | 4% in FVT (240–320 ms) | Not reported | 85% in FVT | 15% in FVT | Not reported | Mean LV EF = 33 ± 13% | 54% of patients were on AAD. No conclusion regarding its effect due to limited duration of follow-up |
Peters et al. [11] | Retrospective study | Spontaneous VT in ICD patients | 6.2% | Female sex aggressive ramp pacing VTCL < 300 ms | 77.1% | 16.5% Predictor of failure: female sex, history of MI, more severe LV dysfunction, being on class I or III AAD, Ramp pacing | ATP was less successful in patients receiving class I& III AAD | Mean LV EF = 35 ± 14% | CAD was one of the predictors of ATP failure |
Nasir et al. [14] | Retrospective study | Spontaneous VT in ICD patients | Less than 2% | Mean VT CL for accelerated episodes = 347 ± 54 ms | 94% | 6% | Not reported | Mean LV EF = 31 ± 12% | Not reported |
Hammil et al. [9] | Non-randomized, retrospective, multicenter study | Induced VT by NIPS in patients with ICD | 12% in LV EF < 40%, 9% in LV EF > 40% | Low LV EF, VTCL < 300 ms, increased number of ATP stimuli | 49% In EF < 40% and 65% in EF > 40%, predictors of ATP success: higher ejection fraction & Long VVT CL | Not reported | No effect of AAD on tachycardia therapy results | Mean LV EF = 36 ± 15% | No effect of underlying structural heart disease on tachycardia therapy results |
Calkins et al. [13] | Prospective study | Induced VT in the EP laboratory | 21% with fixed burst pacing 18% with decremental burst pacing | VTCL < 300 ms | 70% with fixed burst pacing 72% with decremental burst pacing | 9% with fixed burst pacing 10% with decremental burst pacing | No effect of AAD on tachycardia therapy results | Mean LV EF = 34 ± 17% | Not reported |