• Heart Rhythm · Nov 2012

    Antitachycardia pacing reduces appropriate and inappropriate shocks in children and congenital heart disease patients.

    • Yuvraj Kalra, Andrew E Radbill, James A Johns, Frank A Fish, and Prince J Kannankeril.
    • Department of Pediatrics, Vanderbilt University School of Medicine, and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee 37232, USA.
    • Heart Rhythm. 2012 Nov 1; 9 (11): 1829-34.

    BackgroundAntitachycardia pacing (ATP) can reduce implantable cardioverter-defibrillator shocks, but its use in children and patients with congenital heart disease (CHD) is not well described.ObjectiveTo review the efficacy of ATP in children and patients with CHD.MethodsWe reviewed implantable cardioverter-defibrillator therapies in children and patients with CHD (aged 2-52 years) at our institution. Appropriate therapies were defined as those delivered for true ventricular tachycardia (VT) or ventricular fibrillation; other therapies were defined as inappropriate.ResultsDuring a median follow-up of 4 years (range 0.5-15 years), 17 of 79 patients (23%) received appropriate therapy and 14 received ATP for 100 episodes of VT. ATP was highly successful (88%) in terminating VT, and only 10 of 100 episodes required a shock. Shocks were effective in terminating VT/ventricular fibrillation in 21 of 24 episodes (87%). The outcomes of appropriate therapy were similar for ATP and shocks (success 88% vs 87%, failure 9% vs 8%, acceleration 3% vs 4% for ATP and shocks, respectively). Thirty-one patients (39%) received inappropriate therapy. Inappropriate ATP (without subsequent shocks) was delivered to 11 patients for the following: sinus tachycardia (19 episodes in 7 patients) with slowing of the rate after ATP, T-wave oversensing (2 episodes in 2 patients) with loss of oversensing after ATP, and reentrant supraventricular tachycardia (14 episodes in 2 patients) terminated with ventricular ATP.ConclusionsATP is highly efficacious for VT in children and patients with CHD. In addition to reducing appropriate shocks, inappropriate shocks due to sinus or supraventricular tachycardia can be significantly reduced with ATP.Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…