Prospective multicenter randomized trial of fast ventricular tachycardia termination by prolonged versus conventional anti-tachyarrhythmia burst pacing in implantable cardioverter-defibrillator patients-Atp DeliVery for pAiNless ICD thErapy (ADVANCE-D) Trial results

J Interv Card Electrophysiol. 2010 Mar;27(2):127-35. doi: 10.1007/s10840-009-9454-z. Epub 2010 Jan 20.

Abstract

Purpose: The purpose of the trial was to quantify and compare the efficacy of two different sequences of burst anti-tachycardia pacing (ATP) strategies for the termination of fast ventricular tachycardia.

Methods: The trial was prospective, multicenter, parallel and randomized, enrolling patients with an indication for implantable cardioverter-defibrillator implantation.

Results: From February 2004, 925 patients were randomized and followed-up for 12 months. Eight pulses ATP terminated 64% of episodes vs. 70% in the 15-pulse group (p = 0.504). Fifteen pulses proved significantly better in patients without a previous history of heart failure (p = 0.014) and in patients with LVEF >or= 40% (p = 0.016). No significant differences between groups were observed with regard to syncope/near-syncope occurrence.

Conclusion: In the general population, 15-pulse ATP is as effective and safe as eight-pulse ATP. The efficacy of ATP on fast ventricular arrhythmias confirmed once more the striking importance of careful device programming in order to reduce painful shocks.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Cardiac Pacing, Artificial / mortality*
  • Electric Countershock / mortality*
  • Europe
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Risk Assessment / methods
  • Risk Factors
  • Survival Analysis
  • Survival Rate
  • Tachycardia, Ventricular / mortality*
  • Tachycardia, Ventricular / prevention & control*
  • Treatment Outcome