title: Prevention of sustained ventricular tachyarrhythmias in patients with implantable cardioverter-defibrillators-the PREVENT study.
abstract: BACKGROUND
  In patients with implantable cardioverter-defibrillators (ICDs), 25 to 45% of tachyarrhythmia episodes were initiated by short-long-short RR intervals.
  
  
  METHODS
  The prospective multi-center PREVENT study randomized patients implanted with ICDs capable of atrioventricular pacing, in order to compare-using a cross-over design with two 3-month treatment periods-the benefits of 'rate smoothing' (RS) as a 'pause-prevention algorithm' for the prevention of ventricular tachyarrhythmias.
  
  
  RESULTS
  Follow-up included 219 patients with implanted ICDs, of whom 153 were eligible for analysis as per protocol. Fifty-seven of these patients (38%) had documented episodes of ventricular tachyarrhythmias during the six months follow-up. The total number of sustained ventricular tachyarrhythmia episodes was reduced from 358 with RS Off to 145 with RS On. RS was effective in reducing the number of short-long-short induced sustained ventricular episodes from 100 with RS Off to 40 with RS On. The Wilcoxon-Mann-Whitney point estimator equals 0.66 with a 95% confidence interval from 0.51 to 0.82 (relevant superiority; corresponding p = 0.039). There were no proarrhythmic effects due to rate smoothing within the scope of this study.
  
  
  CONCLUSIONS
  'Rate smoothing' significantly reduced sustained ventricular tachyarrhythmias in ICD patients. There is a relevant superiority of the treatment during the early six months of follow-up.
authors: Department of Internal Medicine/Cardiology, Emergency Hospital Berlin, Germany. dietmar.wietholt@ukb.de
authors: Dietmar
authors: D
authors: Wietholt
authors: Volker
authors: V
authors: Kuehlkamp
authors: Ekkhard
authors: E
authors: Meisel
authors: Ellen
authors: E
authors: Hoffmann
authors: Christoph
authors: C
authors: Stellbrink
authors: Joerg
authors: J
authors: Neuzner
authors: Karl
authors: K
authors: Seidl
authors: Peter
authors: P
authors: Szigat
authors: Juergen
authors: J
authors: Potratz
mesh_terms: D000368:Aged; D000465:Algorithms; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D018592:Cross-Over Studies; D017147:Defibrillators, Implantable; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017180:Tachycardia, Ventricular / Q000517:prevention & control*