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Knops, Reinoud E.
[VerfasserIn];
van der Stuijt, Willeke
[VerfasserIn];
Delnoy, Peter Paul H. M.
[VerfasserIn];
Boersma, Lucas V. A.
[VerfasserIn];
Kuschyk, Jürgen
[VerfasserIn];
El-Chami, Mikhael F.
[VerfasserIn];
Bonnemeier, Hendrik
[VerfasserIn];
Behr, Elijah R.
[VerfasserIn];
Brouwer, Tom F.
[VerfasserIn];
Kääb, Stefan
[VerfasserIn];
Mittal, Suneet
[VerfasserIn];
Quast, Anne-Floor B. E.
[VerfasserIn];
Smeding, Lonneke
[VerfasserIn];
Tijssen, Jan G. P.
[VerfasserIn];
Bijsterveld, Nick R.
[VerfasserIn];
Richter, Sergio
[VerfasserIn];
Brouwer, Marc A.
[VerfasserIn];
de Groot, Joris R.
[VerfasserIn];
Kooiman, Kirsten M.
[VerfasserIn];
Lambiase, Pier D.
[VerfasserIn];
Neuzil, Petr
[VerfasserIn];
Vernooy, Kevin
[VerfasserIn];
Alings, Marco
[VerfasserIn];
Betts, Timothy R.
[VerfasserIn];
[...]
Efficacy and safety of appropriate shocks and antitachycardia pacing in transvenous and subcutaneous implantable defibrillators
: analysis of all appropriate therapy in the PRAETORIAN trial
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- Medientyp: E-Artikel
- Titel: Efficacy and safety of appropriate shocks and antitachycardia pacing in transvenous and subcutaneous implantable defibrillators : analysis of all appropriate therapy in the PRAETORIAN trial
- Beteiligte: Knops, Reinoud E. [VerfasserIn]; van der Stuijt, Willeke [VerfasserIn]; Delnoy, Peter Paul H. M. [VerfasserIn]; Boersma, Lucas V. A. [VerfasserIn]; Kuschyk, Jürgen [VerfasserIn]; El-Chami, Mikhael F. [VerfasserIn]; Bonnemeier, Hendrik [VerfasserIn]; Behr, Elijah R. [VerfasserIn]; Brouwer, Tom F. [VerfasserIn]; Kääb, Stefan [VerfasserIn]; Mittal, Suneet [VerfasserIn]; Quast, Anne-Floor B. E. [VerfasserIn]; Smeding, Lonneke [VerfasserIn]; Tijssen, Jan G. P. [VerfasserIn]; Bijsterveld, Nick R. [VerfasserIn]; Richter, Sergio [VerfasserIn]; Brouwer, Marc A. [VerfasserIn]; de Groot, Joris R. [VerfasserIn]; Kooiman, Kirsten M. [VerfasserIn]; Lambiase, Pier D. [VerfasserIn]; Neuzil, Petr [VerfasserIn]; Vernooy, Kevin [VerfasserIn]; Alings, Marco [VerfasserIn]; Betts, Timothy R. [VerfasserIn]; Bracke, Frank A.L.E. [VerfasserIn]; Burke, Martin C. [VerfasserIn]; de Jong, Jonas S. S. G. [VerfasserIn]; Wright, David J. [VerfasserIn]; Jansen, Ward P.J. [VerfasserIn]; Whinnet, Zachary I. [VerfasserIn]; Nordbeck, Peter [VerfasserIn]; Knaut, Michael [VerfasserIn]; Philbert, Berit T. [VerfasserIn]; van Opstal, Jurren M. [VerfasserIn]; Chicos, Alexandru B. [VerfasserIn]; Allaart, Cornelis P. [VerfasserIn]; Borger van der Burg, Alida E. [VerfasserIn]; Clancy, Jude F. [VerfasserIn]; Dizon, Jose M. [VerfasserIn]; Miller, Marc A. [VerfasserIn]; Nemirovsky, Dmitry [VerfasserIn]; Surber, Ralf [VerfasserIn]; Upadhyay, Gaurav A. [VerfasserIn]; Weiss, Raul [VerfasserIn]; de Weger, Anouk [VerfasserIn]; Wilde, Arthur A. M. [VerfasserIn]; Olde Nordkamp, Louise R. A. [VerfasserIn]
- Erschienen: February 1, 2022
- Erschienen in: Circulation ; 145(2022), 5, Seite 321-329
- Sprache: Englisch
- DOI: 10.1161/CIRCULATIONAHA.121.057816
- ISSN: 1524-4539
- Identifikator:
- Schlagwörter: defibrillators, implantable ; electrophysiology ; tachycardia
- Entstehung:
- Anmerkungen:
- Beschreibung: Background: - - The PRAETORIAN trial (A Prospective, Randomized Comparison of Subcutaneous and Transvenous Implantable Cardioverter Defibrillator Therapy) showed noninferiority of subcutaneous implantable cardioverter defibrillator (S-ICD) compared with transvenous implantable cardioverter defibrillator (TV-ICD) with regard to inappropriate shocks and complications. In contrast to TV-ICD, S-ICD cannot provide antitachycardia pacing for monomorphic ventricular tachycardia. This prespecified secondary analysis evaluates appropriate therapy and whether antitachycardia pacing reduces the number of appropriate shocks. - - Methods: - - The PRAETORIAN trial was an international, investigator-initiated randomized trial that included patients with an indication for implantable cardioverter defibrillator (ICD) therapy. Patients with previous ventricular tachycardia <170 bpm or refractory recurrent monomorphic ventricular tachycardia were excluded. In 39 centers, 849 patients were randomized to receive an S-ICD (n=426) or TV-ICD (n=423) and were followed for a median of 49.1 months. ICD programming was mandated by protocol. Appropriate ICD therapy was defined as therapy for ventricular arrhythmias. Arrhythmias were classified as discrete episodes and storm episodes (≥3 episodes within 24 hours). Analyses were performed in the modified intention-to-treat population. - - Results: - - In the S-ICD group, 86 of 426 patients received appropriate therapy, versus 78 of 423 patients in the TV-ICD group, during a median follow-up of 52 months (48-month Kaplan-Meier estimates 19.4% and 17.5%; P=0.45). In the S-ICD group, 83 patients received at least 1 shock, versus 57 patients in the TV-ICD group (48-month Kaplan-Meier estimates 19.2% and 11.5%; P=0.02). Patients in the S-ICD group had a total of 254 shocks, compared with 228 shocks in the TV-ICD group (P=0.68). First shock efficacy was 93.8% in the S-ICD group and 91.6% in the TV-ICD group (P=0.40). The first antitachycardia pacing attempt successfully terminated 46% of all monomorphic ventricular tachycardias, but accelerated the arrhythmia in 9.4%. Ten patients with S-ICD experienced 13 electrical storms, versus 18 patients with TV-ICD with 19 electrical storms. Patients with appropriate therapy had an almost 2-fold increased relative risk of electrical storms in the TV-ICD group compared with the S-ICD group (P=0.05). - - Conclusions: - - In this trial, no difference was observed in shock efficacy of S-ICD compared with TV-ICD. Although patients in the S-ICD group were more likely to receive an ICD shock, the total number of appropriate shocks was not different between the 2 groups. - - Registration: - - URL: https://www.clinicaltrials.gov; Unique identifier: NCT01296022.
- Zugangsstatus: Freier Zugang