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Reactive Arial-based Antitachycardia Pacing Therapy Reduces Atrial Tachyarrhthmias

dc.contributor.authorCrossley, George H.
dc.contributor.authorPadeletti, Luigi
dc.contributor.authorZweibel, Steven
dc.contributor.authorHudnall, Harrison
dc.contributor.authorZhang, Yan
dc.contributor.authorBoriani, Giuseppe
dc.date.accessioned2019-09-25T19:37:41Z
dc.date.available2019-09-25T19:37:41Z
dc.date.issued2019-07
dc.identifier.citationCrossley, GH, Padeletti, L, Zweibel, S, Hudnall, JH, Zhang, Y, Boriani, G. Reactive atrial‐based antitachycardia pacing therapy reduces atrial tachyarrhythmias. Pacing Clin Electrophysiol. 2019; 42: 970– 979. https://doi.org/10.1111/pace.13696en_US
dc.identifier.issn0147-8389
dc.identifier.urihttp://hdl.handle.net/1803/9543
dc.description.abstractBackground Reactive atrial-based antitachycardia pacing (rATP) aims to terminate atrial tachyarrhythmia/atrial fibrillation (AT/AF) episodes when they spontaneously organize to atrial flutter or atrial tachycardia; however, its effectiveness in the real-world has not been studied. We used a large device database (Medtronic CareLink, Medtronic, Minneapolis, MN, USA) to evaluate the effects of rATP at reducing AT/AF. Methods Pacemaker, defibrillator, and resynchronization device transmission data were analyzed. Eligible patients had device detected AT/AF during a baseline period but were not in persistent AT/AF immediately preceding first transmission. Note that 1:1 individual matching between groups was conducted using age, sex, device type, pacing mode, AT/AF, and percent ventricular pacing at baseline. Risks of AT/AF events were compared between patients with rATP-enabled versus control patients with rATP-disabled or not available in the device. For matched patients, AT/AF event rates at 2 years were estimated by Kaplan-Meier method, and hazard ratios (HRs) were calculated by Cox proportional hazard models. Results Of 43,440 qualifying patients, 4,203 had rATP on. Matching resulted in 4,016 pairs, totaling 8,032 patients for analysis. The rATP group experienced significantly lower risks of AT/AF events lasting >= 1 day (HR 0.81), >= 7 days (HR 0.64), and >= 30 days (HR 0.56) compared to control (P < 0.0001 for all). In subgroup analysis, rATP was associated with reduced risks of AT/AF events across age, sex, device type, baseline AT/AF, and preventive atrial pacing. Conclusions Among real-world patients from a large device database, rATP therapy was significantly associated with a reduced risk of AT/AF. This association was independent of whether the patient had a pacemaker, defibrillator, or resynchronization device.en_US
dc.description.sponsorshipMedtronic, Appeared in article as Medtronicen_US
dc.language.isoen_USen_US
dc.publisherPACE-PACING AND CLINICAL ELECTROPHYSIOLOGYen_US
dc.rightsThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
dc.source.urihttps://onlinelibrary.wiley.com/doi/pdf/10.1111/pace.13696
dc.subjectatrial fibrillationen_US
dc.subjectatrial flutteren_US
dc.subjectatrial tachycardiaen_US
dc.subjectdefibrillator;en_US
dc.subjectpacemaker;en_US
dc.subjectpacingen_US
dc.subjectreactive ATPen_US
dc.subjectresynchronizationen_US
dc.subjectBRADYCARDIA PATIENTSen_US
dc.subjectRANDOMIZED-TRIALen_US
dc.subjectHEART-FAILUREen_US
dc.subjectFIBRILLATIONen_US
dc.subjectMINERVAen_US
dc.subjectPERSISTENTen_US
dc.subjectRISKen_US
dc.subjectDEFIBRILLATORen_US
dc.subjectPROGRESSIONen_US
dc.subjectPREVALENCEen_US
dc.subject.lcshAtrial fibrillationen_US
dc.titleReactive Arial-based Antitachycardia Pacing Therapy Reduces Atrial Tachyarrhthmiasen_US
dc.typeArticleen_US
dc.identifier.doi10.1111/pace.13696


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