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Improvement of Quality of Life by Means of Antitachy Pacing: From PainFREE to the ADVANCE-D Trial |
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| Authors: | MAURIZIO LUNATI,PASCAL DEFAYE&dagger ,JOHANN MERMI&Dagger ,ARCADI GARCIA-ALBEROLA§ ,JOSÉ L. MERINO&# ,ANGEL ARENAL¶ ,RICCARDO CAPPATO#,XAVIER NAVARRO,MICAELA PASSARDI&dagger &dagger , MASSIMO SANTINI&Dagger &Dagger |
| Affiliation: | From the Dipartimento di Cardiologia "De Gasperis," AO Niguarda CàGranda, Milano, Italy;, Cardiology and Pneumology Departments, University Hospital, Grenoble, France;, Klinikum Dortmund, Dortmund, Germany;, Cardiology Department, Hospital General Universitario Gregorio Maranon, Madrid, Spain;, Division of Cardiology, La Paz University Hospital, Madrid, Spain;, Laboratorio de Electrofisiologia, Cardiology Department, Hospital General Universitario Gregorio Maranon, Madrid, Spain;, Policlinico San Donato, University of Milan, Milan, Italy;, Medtronica Iberica, Spain;, Medtronica Italia, Rome, Italy;, and Department of Heart Disease, S. Filippo Neri Hospital, Rome, Italy |
| Abstract: | Background: Implantable cardioverter-defibrillators (ICD) can terminate ventricular tachyarrhythmias with shocks (painful) or antitachycardia pacing (painless). According to the results of the Pacing Fast VT Reduces Shock ThErapies Trials, antitachycardia pacing (ATP) can avoid painful shocks and also increase device longevity. The purpose of the ADVANCE-D (Atp DeliVery for PAiNless ICD ThErapy) study is to determine the most appropriate ventricular tachycardia (VT) therapy, so as to optimize painless therapy for life-threatening arrhythmias. Methods and Results: The ADVANCE-D is a prospective, multicenter, parallel, two-arm randomized study designed to evaluate the efficacy of two different sequences of ATP therapies (burst 15 pulses, 88%, vs burst 8 pulses, 88%), during an episode of spontaneous arrhythmia classified as fast VT (FVT) in patients with a Class I or IIA indication for ICD implantation (single and dual chamber devices). The primary endpoint is to compare the efficacy of two ATP therapies for FVT episodes. The study will enroll a minimum of 900 patients within 2 years, followed-up for 12 months. The investigation is expected to be completed in 2007. Conclusions: The ADVANCE-D trial is the first large randomized clinical investigation aimed to evaluate optimal programming and efficacy of ATP. |
| Keywords: | ventricular tachyarrhythmias implantable cardioverter/defibrillator antitachycardia pacing |