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Letter to the Editor| Volume 20, ISSUE 3, P479, March 2023

To the Editor—Programming more ATP sequences is not a case of no harm, no foul

Published:December 08, 2022DOI:https://doi.org/10.1016/j.hrthm.2022.12.011
      We read with interest the retrospective analysis of the PainFree SmartShock Technology (SST) cohort by Sterns et al.
      • Sterns L.D.
      • Auricchio A.
      • Schloss E.J.
      • et al.
      Antitachycardia pacing success in implantable cardioverter defibrillators by patient, device, and programming characteristics.
      Their results confirm that antitachycardia pacing (ATP) can terminate monomorphic ventricular tachycardias (VTs). However, we are concerned about their recommendation to program multiple ATP sequences.
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      References

        • Sterns L.D.
        • Auricchio A.
        • Schloss E.J.
        • et al.
        Antitachycardia pacing success in implantable cardioverter defibrillators by patient, device, and programming characteristics.
        Heart Rhythm. 2022 Oct 19; S1547-5271 (–6): 02517
        • Knops R.E.
        • van der Stuijt W.
        • Delnoy P.
        • et al.
        Efficacy and safety of appropriate shocks and antitachycardia pacing in transvenous and subcutaneous implantable defibrillators: analysis of all appropriate therapy in the PRAETORIAN trial.
        Circulation. 2022; 145: 321-329
        • Wang W.
        • Gasperetti A.
        • Sears S.F.
        • et al.
        Subcutaneous and transvenous defibrillators in arrhythmogenic right ventricular cardiomyopathy: a comparison of clinical and quality-of-life outcomes.
        JACC Clin Electrophysiol. 2022 Oct 21; S2405-500X (–5): 00846

      Linked Article

      • Reply to the Editor—Programming more ATP sequences is not a case of no harm, no foul
        Heart RhythmVol. 20Issue 3
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          We would like to thank van der Stuijt et al for their comments on our article. In their letter, they suggest minimizing antitachycardia pacing (ATP) trains with initial programming, and recommend using more ATP trains only if the initial ATP is successful. This is based on their analysis of the results of the PRAETORIAN study, in which patients with transvenous implantable cardioverter-defibrillators (ICDs) with ATP capability were found to have a borderline greater number of electrical storm events.
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