Reactive Atrial-based Antitachycardia Pacing Linked With Reduced AT/AF

This study looked at the real-world effectiveness of atrial-based antitachycardia pacing (rATP) for the treatment of atrial tachyarrhythmia (AT/AF) episodes based on information from a large-scale (Medtronic CareLink) device database. The researchers looked at pacemaker, defibrillator and resynchronization device transmission data from eligible patients in which AT/AF was detected during a baseline period but who were not in persistent AT/AF. The researchers matched participants 1:1 between study groups using age, sex, device, pacing mode, AT/AF, and percent ventricular pacing at baseline. They evaluated event rates at two years as estimated by the Kaplan-Meier method.  According to the results, of 43,440 qualifying patients, 4,203 had rATP on (who were matched in 4,016 pairs), for a total of 8,032 patients included in the analysis. The rATP group had lower risks for AT/AF events lasting a day or longer, a week or longer, and a month or longer compared to the controls (P<0.0001 for all comparisons). Subgroup analysis revealed that rATP was linked with lower AT/AF event rates across age, sex, device type, baseline AT/AF, and preventive atrial pacing.