Work

Difference in the efficacy of atrial antitachycardia pacing for suppression of ventricular arrhythmias

Year: 2026

Type: article

Abstract: Background Intermittent atrial tachyarrhythmias (ATAs) are associated with ventricular arrhythmias (VAs), particularly in patients with left ventricular dysfunction. Little is known about the effect of atrial antitachycardia pacing (Reactive ATP [rATP]) on the reduction of VAs in patients with a shock device. Objectives We examined differences in the efficacy of rATP in the suppression of VAs in patients with a shock device. Methods Overall, among 589 consecutive patients with a shock device, we analyzed those with a history of intermittent ATAs and a cardiac resynchronization therapy device with defibrillator (CRTD, n=112) or an implantable cardioverter defibrillator (ICD, n=32). The study subjects were categorized into two groups based on availability of rATP; rATP group: 72 pts and No-rATP group: 72 pts). Primary outcome was VA events treated by ventricular ATP or shock, or lasted ≥30 seconds. Results During a median follow-up of 862 days, the rATP group (n=55) had a significantly lower risk of VAs compared with the no-rATP group (n=57) (log rank p=0.02); moreover, rATP was an independent negative predictor of VAs (hazard ratio [HR]: 0.42, 95% confidence interval [CI]: 0.21–0.84, p=0.01) among patients with CRTD, whereas there was no significant difference between the rATP group (n=17) and the no-rATP group (n=15) among patients with ICD (HR: 0.59, 95%CI: 0.10–3.55, p=0.57). Conclusion Reactive ATP was significantly associated with a lower risk of VAs in patients with CRTD and intermittent ATAs, but not in patients with an ICD.

Source: Heart Rhythm O2

DOI: 10.1016/j.hroo.2026.01.007