Ventricular tachycardia induced by antitachycardia pacing for ventricular tachycardia: Not so pain-free?

Antitachycardia pacing (ATP) has an important role in reducing shocks and improving quality of life and device longevity in patients with an implantable cardioverter –defibrillator (ICD) and monomorphic ventricular tachycardia (VT).1–4 ATP interrupts reentry, presumably by blocking conduction in a reentrant circuit. However, when multiple potential reentrant paths are present, pacing can alter the reentrant circuit path or initiate reentry in another circuit , changing the VT. The PainFREE Rx II trial demonstrated that ATP was effective for fast (between 188 and 250 bpm) VTs without increasing syncope or decreasing efficacy of a subsequent shock compared to slower VTs.
Source: Heart Rhythm - Category: Cardiology Authors: Tags: Editorial Commentary Source Type: research