Abstract
BACKGROUND: The clinical outcomes of a novel antitachycardia pacing (ATP) algorithm-intrinsic ATP (iATP)-compared to conventional ATP (cATP) have yet to be fully elucidated. METHODS: This retrospective study analyzed 128 patients and 1962 ventricular tachycardia (VT) episodes treated with the iATP or the cATP at Kokura Memorial Hospital. Patients were categorized into two groups: the iATP group (23 patients, 182 episodes) and the cATP group (105 patients, 1780 episodes). We evaluated ATP success rates and baseline patient characteristics on a per-patient basis. Additionally, we extracted VT that were not terminated by a single ATP and compared ATP success rates using propensity score matching. RESULTS: Per patient; The iATP group exhibited significantly lower creatinine levels (1.18 ± 0.40 mg/dL vs. 1.82 ± 1.61 mg/dL, p = .021) and a shorter follow-up period (609 ± 323 days vs. 1017 ± 252 days, p < .001) compared to the cATP group. ATP success was observed in 19 patients in the iATP group and 62 patients in the cATP group (82.6% vs. 59%, p = .054). Per episode; there was no significant difference in ATP success rate (91.8% vs. 92.7%, p = .645) or in acceleration rate (1.1% vs. 2.4%, p = .274). However, when limited to episodes in which VT was not terminated by a single ATP and propensity score matching was performed, the iATP showed a higher VT termination rate (84.1% vs. 53.6%, p < .001) and a lower acceleration rate (0% vs. 10.1%, p = .013) than the cATP. CONCLUSIONS: The efficacy and safety of the iATP for VT that was not terminated by the first sequence of ATP was demonstrated.