Arrhythmias & electrophysiologyRandomised controlled trial

Assessment of Antitachycardia Pacing in Primary Prevention Patients

JAMAPublished

  • Randomised controlled trial
  • 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

Authors' 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
Antitachycardia pacing (ATP) plus shock vs shock only
Primary endpoint
Time to first all-cause shock
Follow-up
Mean 38 months

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. JAMA. Published 26 November 2024. doi:10.1001/jama.2024.16531

Summarised from the published abstract; every number is checked against it