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Local Activation Time Derived from Stored EGM is Associated with Failure of Antitachycardia Pacing in Patients with Implantable Defibrillator
Author(s) -
LIM HOONG SERN,
LENCIONI MAURO,
MARSHALL HOWARD
Publication year - 2010
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2009.02638.x
Subject(s) - medicine , cardiology , ventricular tachycardia , implantable cardioverter defibrillator , tachycardia , intracardiac injection
Background: Antitachycardia pacing (ATP) is an effective treatment of ventricular tachycardia (VT). However, persistent failure of ATP in some patients is well recognized.Methods: A method of deriving the local activation time from stored intracardiac electrograms in implantable cardioverter defibrillators is described. Using a case‐control design, the local activation times were compared between patients with persistent unsuccessful ATP with comparable controls with successful ATP.Results: The local activation times during VT in patients with failed ATP were longer at 120–180 ms compared with corresponding control patients with successful ATP (60–80 ms). The local activation time expressed as a proportion of VT cycle length in patients with failed ATP compared with patients with successful ATP were 0.40 ± 0.08 versus 0.19 ± 0.08 (P = 0.012).Conclusion: A novel method of deriving local activation time is described, and delayed local activation time may explain failure of ATP in terminating VT in some patients. (PACE 2010; 549–552)