title: Improvement of quality of life by means of antitachy pacing: from PainFREE to the ADVANCE-D Trial.
abstract: BACKGROUND
  Implantable cardioverter-defibrillators (ICD) can terminate ventricular tachyarrhythmias with shocks (painful) or antitachycardia pacing (painless). According to the results of the Pacing Fast VT Reduces Shock ThErapies Trials, antitachycardia pacing (ATP) can avoid painful shocks and also increase device longevity. The purpose of the ADVANCE-D (Atp DeliVery for PAiNless ICD ThErapy) study is to determine the most appropriate ventricular tachycardia (VT) therapy, so as to optimize painless therapy for life-threatening arrhythmias.
  
  
  RESULTS
  The ADVANCE-D is a prospective, multicenter, parallel, two-arm randomized study designed to evaluate the efficacy of two different sequences of ATP therapies (burst 15 pulses, 88%, vs burst 8 pulses, 88%), during an episode of spontaneous arrhythmia classified as fast VT (FVT) in patients with a Class I or IIA indication for ICD implantation (single and dual chamber devices). The primary endpoint is to compare the efficacy of two ATP therapies for FVT episodes. The study will enroll a minimum of 900 patients within 2 years, followed-up for 12 months. The investigation is expected to be completed in 2007.
  
  
  CONCLUSIONS
  The ADVANCE-D trial is the first large randomized clinical investigation aimed to evaluate optimal programming and efficacy of ATP.
authors.affiliation: Dipartimento di Cardiologia "De Gasperis," AO Niguarda Cà Granda, Milano, Italy. maurizio.lunati@ospedaleniguarda.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Lunati
authors.forename: Pascal
authors.initials: P
authors.lastname: Defaye
authors.forename: Johann
authors.initials: J
authors.lastname: Mermi
authors.forename: Arcadi
authors.initials: A
authors.lastname: Garcia-Alberola
authors.forename: José L
authors.initials: JL
authors.lastname: Merino
authors.forename: Angel
authors.initials: A
authors.lastname: Arenal
authors.forename: Riccardo
authors.initials: R
authors.lastname: Cappato
authors.forename: Xavier
authors.initials: X
authors.lastname: Navarro
authors.forename: Micaela
authors.initials: M
authors.lastname: Passardi
authors.forename: Massimo
authors.initials: M
authors.lastname: Santini
mesh_terms: D002304:Cardiac Pacing, Artificial / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000517:prevention & control*; D016896:Treatment Outcome