title: Effectiveness of antitachycardia pacing therapy after primary prophylaxis implantation of implantable defibrillators in coronary artery disease patients.
abstract: OBJECTIVE
  Effectiveness of implantable defibrillators (ICD) has been proven with large randomized trials. Unfortunately, ICD discharge is painful and potentially threatening for the patient despite its life saving effects. We analyzed influence of the clinical parameters present before implantation on the effectiveness of antitachycardia pacing therapy (ATP) in terminating ventricular tachycardia (VT) slower than 200 bpm in the coronary artery disease patients with prophylactic implanted ICD in a single centre retrospective trial.
  
  
  METHODS
  We analyzed 121 consecutive coronary disease patients with ICD implanted in primary prophylaxis between 2001 and 2007, with the mean age of 62 ± 10 years. The mean follow-up was 876 ± 538 days.
  
  
  RESULTS
  32 of them had VT. In 27 persons (84.4%) at least one ATP attempt terminate VT. ATP was always successful in 21 patients. We analyzed age, sex, LVEF, NYHA class, widening of QRS complex, atrial fibrillation, type of myocardial infarction or diabetes. There were no significant differences in clinical features between patients with successful and unsuccessful ATP therapy.
  
  
  CONCLUSIONS
  High effectiveness of ATP was shown in this group. There were no clinical factors indicating success of this type of therapy. That could justify programming ATP as the first line therapy in the VT zone in primary prophylaxis coronary artery disease patients to reduce application of shock therapy. It should be possible to apply a single mode of programming when discharging patients after the implantation procedure regardless of the patient's clinical condition. This could help to control and programme the devices, thus reducing the risk of errors.
authors.affiliation: 2nd Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland. Electronic address: maciag_o@poczta.onet.pl.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Maciąg
authors.affiliation: Department of Arrhythmia, Institute of Cardiology, Warsaw, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Przybylski
authors.affiliation: 2nd Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Sterliński
authors.affiliation: 2nd Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Lewandowski
authors.affiliation: 2nd Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Gepner
authors.affiliation: 2nd Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Syska
authors.affiliation: 2nd Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Pytkowski
authors.affiliation: 2nd Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Edyta
authors.initials: E
authors.lastname: Smolis-Bąk
authors.affiliation: 2nd Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Szwed
mesh_terms: D000328:Adult; D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013610:Tachycardia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
keywords: Antitachycardia pacing; Implantable cardioverter-defibrillators