Prospective multicenter randomized trial of fast ventricular tachycardia termination by prolonged versus conventional anti-tachyarrhythmia burst pacing in implantable cardioverter-defibrillator patients-Atp DeliVery for pAiNless ICD thErapy (ADVANCE-D) Trial results.
OBJECTIVE
The purpose of the trial was to quantify and compare the efficacy of two different sequences of burst anti-tachycardia pacing (ATP) strategies for the termination of fast ventricular tachycardia.


METHODS
The trial was prospective, multicenter, parallel and randomized, enrolling patients with an indication for implantable cardioverter-defibrillator implantation.


RESULTS
From February 2004, 925 patients were randomized and followed-up for 12 months. Eight pulses ATP terminated 64% of episodes vs. 70% in the 15-pulse group (p = 0.504). Fifteen pulses proved significantly better in patients without a previous history of heart failure (p = 0.014) and in patients with LVEF >or= 40% (p = 0.016). No significant differences between groups were observed with regard to syncope/near-syncope occurrence.


CONCLUSIONS
In the general population, 15-pulse ATP is as effective and safe as eight-pulse ATP. The efficacy of ATP on fast ventricular arrhythmias confirmed once more the striking importance of careful device programming in order to reduce painful shocks.
Santini
Massimo
M
Ospedale S. Filippo Neri, Roma, Italy. m.santini@rmnet.it
Lunati
Maurizio
M
Defaye
Pascal
P
Mermi
Johann
J
Proclemer
Alessandro
A
del Castillo-Arroys
Silvia
S
Molon
Giulio
G
Santi
Elisabetta
E
De Santo
Tiziana
T
Navarro
Xavier
X
Kloppe
Axel
A
D002304:Cardiac Pacing, Artificial / Q000401:mortality*; D004554:Electric Countershock / Q000401:mortality*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000401:mortality* / Q000517:prevention & control*; D016896:Treatment Outcome