Antitachycardia pacing refers to the treatment delivered by implantable cardioverter-defibrillators (ICDs) or pacemakers that uses precisely timed electrical pulses to interrupt and terminate certain types of tachycardias.
Implantable cardioverter-defibrillators (ICDs) or pacemakers detect a dangerous fast heart rhythm, typically ventricular tachycardia (VT),and delivering a series of electrical pulses slightly faster than the patient’s tachycardia.
This overdrive pacing can capture control of the heart rhythm, then gradually slows down, bringing the heart rate back to normal rhythm.
The main advantages of ATP include: painless, unlike defibrillation shocks It can terminate many episodes of VT before they require shocking It helps preserve battery life of the device improves quality of life for patients
ATP is particularly effective for managing monomorphic ventricular tachycardia, slower VTs under 200 beats per minute and reentrant tachycardias.
If ATP fails to terminate the arrhythmia after a programmed number of attempts, the device will proceed to deliver a shock if necessary.
The use of a single burst of ATP prior to shock in primary prevention ICD recipients can prolong the time to first all cause ICD shock (APPRAISE ATP investigators): the reduction in first all cause ICD shock did not extend to a reduction in all cause shock, burden or mortality as there was only a one percent absolute reduction in all cause shock due to ATP.