Myocardial Minimal Damage After Rapid Ventricular Pacing - the prospective randomized multicentre MyDate-Trial.
Aged
Biomarkers
/ blood
Cardiac Pacing, Artificial
/ adverse effects
Cardiomyopathies
/ diagnosis
Death, Sudden, Cardiac
/ prevention & control
Defibrillators, Implantable
/ adverse effects
Female
Humans
Intraoperative Care
/ adverse effects
Male
Middle Aged
Prospective Studies
Tachycardia, Ventricular
/ therapy
Troponin T
/ blood
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
16 03 2020
16 03 2020
Historique:
received:
15
08
2019
accepted:
01
03
2020
entrez:
18
3
2020
pubmed:
18
3
2020
medline:
15
12
2020
Statut:
epublish
Résumé
Therapy of choice for the primary and secondary prevention of sudden cardiac death is the implantation of an implantable cardioverter defibrillator (ICD). Whereas appropriate and inappropriate ICD shocks lead to myocardial microdamage, this is not known for antitachycardia pacing (ATP). In total, 150 ICD recipients (66 ± 12 years, 81.3% male, 93.3% primary prevention, 30.0% resynchronization therapy) were randomly assigned to an ICD implantation with or without intraoperative ATP. In the group with ATP, the pacing maneuver was performed twice, each time applying 8 impulses à 6 Volt x 1.0 milliseconds to the myocardium. High sensitive Troponin T (hsTnT) levels were determined prior to the implantation and thereafter. There was no significant difference in the release of hsTnT between the two randomization groups (delta TnT without ATP in median 0.010 ng/ml [min. -0.016 ng/ml-max. 0.075 ng/ml] vs. with ATP in median 0.013 ng/ml [min. -0.005-0.287 ng/ml], p = 0.323). Setting a hsTnT cutoff of 0.059 ng/dl as a regularly augmented postoperative hsTnT level, no relevant difference between the two groups regarding the postoperative hsTnT levels above this cutoff could be identified (without ATP n = 10 [14.7%] vs. with ATP n = 16 [21.9%], p = 0.287). There was no significant difference in the release of high sensitive Troponin between patients without intraoperative ATP compared to those with intraoperative ATP. Hence, antitachycardia pacing does not seem to cause significant myocardial microdamage. This may further support its use as a painless and efficient method to terminate ventricular tachycardia in high-risk patients.
Identifiants
pubmed: 32179792
doi: 10.1038/s41598-020-61625-8
pii: 10.1038/s41598-020-61625-8
pmc: PMC7075963
doi:
Substances chimiques
Biomarkers
0
Troponin T
0
Types de publication
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
4753Références
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