Arrhythmias & electrophysiology
Assessment of Antitachycardia Pacing in Primary Prevention Patients: The APPRAISE Antitachycardia Pacing (ATP) Randomized Clinical Trial
Primary result · First all-cause shockResult — go to the resultHazard ratio 0.72 95.9% CI 0.57–0.92Authors' conclusion
The use of a single burst of ATP prior to shock in primary prevention ICD recipients with modern ICD detection programming prolonged the time to first all-cause ICD shock.
Study context
- Population
- Primary prevention implantable cardioverter-defibrillator (ICD) recipients (LVEF ≤35%) with contemporary programming
- Participants
- 2,595 recipients
- Comparison
- ATP plus shock vs shock only
- Primary endpoint
- Time to first all-cause shock
- Follow-up
- Mean 38 months
Methodological detailsdouble-blind, equivalence design (relative margin 35%), superiority tests at interim and final analyses, global, 134 sites in 8 countries, Enrolled September 2016 to April 2021; last follow-up July 6, 2023
- Double-blind
- Equivalence design (relative margin 35%)
- Superiority tests at interim and final analyses
- Global, 134 sites in 8 countries
- Enrolled September 2016 to April 2021; last follow-up July 6, 2023
Primary result
First all-cause shock
Hazard ratio
0.72
95.9% CI 0.57–0.92
P = 0.005
Events by treatment group
ATP plus shock
129
events
Shock only
178
events
ATP plus shock vs Shock only
HR 0.72 (95.9% CI 0.57–0.92); P = 0.005
As reported in the abstract
Secondary outcomes
Total shock burden per 100 patient-years · during follow-up · not statistically different · intention-to-treat
P = 0.70
Original publication
Assessment of Antitachycardia Pacing in Primary Prevention Patients: The APPRAISE ATP Randomized Clinical Trial. JAMA. Published 26 November 2024. doi:10.
Summarised from the published abstract; every number is checked against it