TY - JOUR
T1 - Impact of device programming on the success of the first anti-tachycardia pacing therapy
T2 - An anonymized large-scale study
AU - Shakibfar, Saeed
AU - Krause, Oswin
AU - Lund-Andersen, Casper
AU - Strycko, Filip
AU - Moll, Jonas
AU - Osman Andersen, Tariq
AU - Høgh Petersen, Helen
AU - Hastrup Svendsen, Jesper
AU - Igel, Christian
PY - 2019/8/1
Y1 - 2019/8/1
N2 - Background Antitachycardia pacing (ATP) is an effective treatment for ventricular tachycardia (VT). We evaluated the efficacy of different ATP programs based on a large remote monitoring data set from patients with implantable cardioverter-defibrillators (ICDs). Methods A dataset from 18,679 ICD patients was used to evaluate the first delivered ATP treatment. We considered all device programs that were used for at least 50 patients, leaving us with 7 different programs and a total of 32,045 episodes. We used the two-proportions z-test (α = 0.01) to compare the probability of success and the probability for acceleration in each group with the corresponding values of the default setting. Results Overall, the first ATP treatment terminated in 78.4%–97.5% of episodes with slow VT and 81.5%–91.1% of episodes with fast VT. The default setting of the ATP programs with the number of sequences S = 3 was applied to treat 30.1% of the slow and 36.6% of the fast episodes. Reducing the maximum number of sequences to S = 2 decreased the success rate for slow VT (P < 0.0001, h = 0.38), while the setting S = 4 resulted in the highest success rate of 97.5% (P < 0.0001, h = 0.27). Conclusion While the default programs performed well, we found that increasing the number of sequences from 3 to 4 was a promising option to improve the overall ATP performance.
AB - Background Antitachycardia pacing (ATP) is an effective treatment for ventricular tachycardia (VT). We evaluated the efficacy of different ATP programs based on a large remote monitoring data set from patients with implantable cardioverter-defibrillators (ICDs). Methods A dataset from 18,679 ICD patients was used to evaluate the first delivered ATP treatment. We considered all device programs that were used for at least 50 patients, leaving us with 7 different programs and a total of 32,045 episodes. We used the two-proportions z-test (α = 0.01) to compare the probability of success and the probability for acceleration in each group with the corresponding values of the default setting. Results Overall, the first ATP treatment terminated in 78.4%–97.5% of episodes with slow VT and 81.5%–91.1% of episodes with fast VT. The default setting of the ATP programs with the number of sequences S = 3 was applied to treat 30.1% of the slow and 36.6% of the fast episodes. Reducing the maximum number of sequences to S = 2 decreased the success rate for slow VT (P < 0.0001, h = 0.38), while the setting S = 4 resulted in the highest success rate of 97.5% (P < 0.0001, h = 0.27). Conclusion While the default programs performed well, we found that increasing the number of sequences from 3 to 4 was a promising option to improve the overall ATP performance.
U2 - 10.1371/journal.pone.0219533
DO - 10.1371/journal.pone.0219533
M3 - Journal article
C2 - 31393871
SN - 1932-6203
VL - 14
JO - PLoS Computational Biology
JF - PLoS Computational Biology
IS - 8
M1 - e0219533
ER -