Efficacy of atrial antitachycardia pacing using the Medtronic AT500 pacemaker in patients with congenital heart disease
Abstract
Patients with congenital heart disease are vulnerable to atrial tachyarrhythmias, especially after atrial surgeries. We evaluated the efficacy of atrial arrhythmia detection and antitachycardia pacing (ATP) using the Medtronic AT500 pacemaker in 28 patients with congenital heart disease (age 30 +/- 18 years). Of 15 patients with atrial arrhythmias, 14 had atrial tachycardia events that were appropriately detected. ATP was enabled for 167 treatable episodes, successfully converting 90 (54%). Rhythms classified as ventricular tachycardia were detected 127 times, yet most were actually atrial or sinus tachycardia with 1:1 atrioventricular conduction. Atrial tachycardias in congenital heart disease are amenable to ATP algorithms in the AT500 pacemaker.
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Atrial pacing at rates above the flutter rate via a transvenous catheter can terminate atrial flutter in a large proportion of cases.
“Alternatively, AFL interruption can be achieved in a large percentage of cases by atrial pacing at rates above the AFL rate, through a transvenous catheter.”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [148]
High-output stimulation can also be delivered through the oesophagus to terminate atrial flutter.
“Using high output stimulation this technique can also be applied through the oesophagus.145 -148”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [148]
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- Authors
- Stephenson, E. A., Casavant, D., Tuzi, J., Alexander, M. E., Law, I., Serwer, G., Strieper, M., Walsh, E. P., & Berul, C. I.
- Affiliations
- Boston Children's Hospital (US)
- Medtronic (United States) (US)
- Harvard University (US)
- University of Iowa (US)
- Children's Healthcare of Atlanta (US)
- Corresponding author
- Berul, Charles I.
- ORCID
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2003-10
- Volume
- 92
- Issue
- 7
- Pages
- 871-876
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2107655703
- Cited by
- 141
- References
- 22
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2022: 7 · 2021: 10 · 2020: 1 · 2019: 4 · 2018: 10 · 2017: 10 · 2016: 4 · 2015: 15 · 2014: 6 · 2013: 4 · 2012: 9
- FWCI
- 4.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Keywords
- congenital heart disease, atrial tachycardia, atrial arrhythmia detection, atrioventricular conduction, postoperative arrhythmia, implantable cardioverter-defibrillator
- MeSH terms
- Adolescent, Adult, Aged, Atrial Fibrillation, Atrial Flutter, Cardiac Pacing, Artificial, Child, Female, Follow-Up Studies, Heart Defects, Congenital, Humans, Male, Middle Aged, Pacemaker, Artificial, Tachycardia, Atrioventricular Nodal Reentry, Tachycardia, Supraventricular, Treatment Outcome
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