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3. 7.8 Tolerability of atrial fibrillation (AF) prevention algorithms

Author

Cervellati, D., primary, Propato, N., additional, Mambelli, M., additional, Tartagni, F., additional, Ricci, S., additional, Pignatd, F., additional, Melandri, F., additional, Fontana, P., additional, Orazi, S., additional, Mené, A., additional, Reggiani, A., additional, and Pepi, P., additional

Published
2003
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7. Randomized comparison between Ramp and Burst+ atrial antitachycardia pacing therapies in patients suffering from sinus node disease and atrial fibrillation and implanted with a DDDRP device

Author

Giuseppe Boriani, Andrea Grammatico, Michele Massimo Gulizia, Ignazio Vaccaro, S. Mangiameli, Serafino Orazi, Giacomo Chiarandà, Guglielmo Piccione, Giuseppe Scardace, Calogero Puntrello, Calogero Vasco, Andrea Colletti, Gaetano Butera, Nicolò DiGiovanni, Gulizia M, Mangiameli S, Orazi S, Chiaranda G, Boriani G, Piccione G, DiGiovanni N, Colletti A, Puntrello C, Butera G, Vasco C, Vaccaro I, Scardace G, and Grammatico A

Subjects
Male, Tachycardia, law.invention, Randomized controlled trial, law, Atrial Fibrillation, 80 and over, Medicine, Prospective Studies, Sinus, Aged, 80 and over, education.field_of_study, Cross-Over Studies, Statistics, Cardiac Pacing, Artificial, Aged, Arrhythmia, Sinus, Chi-Square Distribution, Female, Humans, Italy, Least-Squares Analysis, Middle Aged, Quality of Life, Statistics, Nonparametric, Treatment Outcome, Atrial fibrillation, medicine.anatomical_structure, Artificial, Cardiology, medicine.symptom, Cardiology and Cardiovascular Medicine, Arrhythmia, medicine.medical_specialty, Population, Physiology (medical), Internal medicine, Nonparametric, education, Atrial tachycardia, business.industry, Sinoatrial node, medicine.disease, Antitachycardia Pacing, Artificial cardiac pacemaker, Cardiac Pacing, business
Abstract

Atrial tachycardia and flutter frequently occur in association with atrial fibrillation and may be treated by overdrive pacing in patients who receive pacemakers with antitachycardia pacing (ATP) capabilities. The PITAGORA trial was a multi-centre, randomized, cross-over study aimed at comparing two different ATP modes for atrial tachyarrhythmia (AT) termination in patients suffering from sinus node disease (SND). METHODS AND RESULTS: One hundred and seventy-six patients (72 M, age 71+/-9 years) received a Medtronic AT500 pacemaker. All patients were on class IC or III antiarrhythmic drugs. After a 5-month observation period, 170 patients were randomized to either Ramp or Burst+ ATP therapy; 4 months later they crossed over. One hundred and fifty-seven patients completed the 13 months of follow-up; 114 (72.6%) suffered 6088 AT episodes. In 75 patients, 1904 AT episodes were treated and 934 (49.1%) successfully terminated. The median value of individual patients' ATP efficacy was 60%. Burst+ terminated 387 out of 873 AT episodes (44%) in 58 patients. Ramp terminated 547 out of 1031 AT episodes (53%, P240 ms. Quality of life, as measured by the EuroQoL questionnaire, and number of symptoms significantly improved in the overall population. This improvement was significantly higher in patients with ATP efficacy >60%. CONCLUSION: In patients suffering from SND and AT, Ramp therapy shows higher termination efficacy than Burst+ therapy in AT episodes with ATCL >240 ms. Further studies are required to show the impact of ATP on clinical outcomes.

Published
2006
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