Results of delivered therapy for VT or VF in patients with third-generation implantable cardioverter defibrillators.
Third-generation implantable cardioverter defibrillators (ICDs) offer tiered therapy and can provide significant advantage in the management of patients with life-threatening arrhythmias. Three different types of ICDs were implanted in 21 patients with ventricular tachycardia (VT) or ventricular fibrillation (VF). Arrhythmia presentation was VT (76%), VF (10%), or both (14%). The mean left ventricular ejection fraction for the group was 32.4 +/- 7%. No surgical mortality occurred. Prior to discharge individual EPS determined the final programmed settings of the ICDs. During a mean follow-up of 13 +/- 1.4 months (range 2-20) the overall patient survival was 85.7%. No sudden arrhythmic or cardiac death occurred. Twenty of 21 patients (95%) received therapy by their device. In 14 patients (67%) antitachycardia pacing (ATP) was programmed "on," 13 of which was self-adaptative autodecremental mode. There were 247 VT episodes, 231 of which were subjected to ATP with 97% success and 3% acceleration or failure. Low energy shocks reverted all other VT episodes. VF episodes were successfully reverted by a single shock (93%), two shocks (6%), or three shocks (1%). We conclude that ATP therapy of VT is successful in the large majority of episodes with rare failures, and that VF episodes are generally terminated by a single ICD shock.
Rabinovich
R
R
Muratore
C
C
Iglesias
R
R
Gonzalez
M
M
Serafrica
M
M
Sosa Liprandi
A
A
D002304:Cardiac Pacing, Artificial; D017147:Defibrillators, Implantable; D004594:Electrophysiology; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012189:Retrospective Studies; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000453:epidemiology / Q000628:therapy*; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000453:epidemiology / Q000628:therapy*