Incidence and clinical relevance of slow ventricular tachycardia in implantable cardioverter-defibrillator recipients: an international multicenter prospective study.

Abstract

BACKGROUND:

This study aims to assess the incidence and clinical relevance of slow ventricular tachycardia (VT) and the effectiveness and/or deleterious effects of antitachycardia pacing in slow VT in implantable cardioverter-defibrillator recipients.

METHODS AND RESULTS:

This multicenter prospective randomized study included 374 patients (326 men) without prior history of slow VT (<148 bpm) implanted with a dual-chamber implantable cardioverter-defibrillator. Patients had a 3-zone detection configuration: a slow VT zone (101 to 148 bpm), a conventional VT zone (>148 bpm), and a ventricular fibrillation zone. Patients were randomized to a treatment group (n=183) with therapy activated in the slow VT zone or a monitoring group (n=191) with no therapy in the slow VT zone. During follow-up (11 months), 449 slow VTs occurred in 114 patients (30.5% slow VT incidence); 181 VTs (54 patients) occurred in the monitoring group; 3 were readmitted to the hospital; and lightheadedness and palpitations occurred in 4 and 250 (60 patients) in the treatment group treated by antitachycardia pacing (89.8% success rate) and shock delivery (n=2). There were 10 crossovers from the monitoring to treatment group and 3 crossovers from the treatment to monitoring group (P=0.09). Quality of life scores were not different between groups.

CONCLUSIONS:

Slow VT incidence (<150 bpm) is high (30%) in implantable cardioverter-defibrillator recipients without prior history of slow VT, has limited clinical relevance, and is efficiently and safely terminated by antitachycardia pacing.

• Authors: Nicolas Sadoul, Ralph Mletzko, Frédéric Anselme, Robert Bowes, Wolfgang Schöls, Claude Kouakam, Gaëlle Casteigneau, Raffaele Luise, Nicolas Iscolo, Etienne Aliot, Slow VT Study Group
• Journal: Circulation (Circulation) Vol. 112 Issue 7 Pg. 946-53 (Aug 16 2005) ISSN: 1524-4539 [Electronic] United States
• PMID: 16103252 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Arrhythmia Agents

Topics

• Adult
• Aged
• Aged, 80 and over
• Algorithms
• Anti-Arrhythmia Agents (therapeutic use)
• Cross-Over Studies
• Defibrillators, Implantable (adverse effects)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Prospective Studies
• Reproducibility of Results
• Survival Analysis
• Tachycardia, Ventricular (mortality, therapy)
• Treatment Outcome