4 research outputs found
A randomised comparison between Ramp and Burst+ atrial antytachycardia pacing therapies in patients suffering from bradycardia and atrial fibrillation and implanted with a DDDRP device.
A randomised comparison between Ramp and Burst+ atrial antitachycardia pacing therapies in patients suffering from bradycardia and atrial fibrillation and implanted with a DDDRP device
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.
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%, P<0.001) in 56 patients. Ramp
efficacy was significantly (P<0.01) and directly correlated with AT cycle length
(ATCL), whereas Burst+ efficacy was not. Ramp showed higher (P<0.001)
termination efficacy than Burst+ for ATCL >240 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
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.
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%, P<0.001) in 56 patients. Ramp
efficacy was significantly (P<0.01) and directly correlated with AT cycle length
(ATCL), whereas Burst+ efficacy was not. Ramp showed higher (P<0.001)
termination efficacy than Burst+ for ATCL >240 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