RR interval variability in the evaluation of ventricular tachycardia and effects of implantable cardioverter defibrillator therapy

Keita Tsukahara, Yasushi Oginosawa, Yoshihisa Fujino, Toshihiro Honda, Kan Kikuchi, Masatsugu Nozoe, Takayuki Uchida, Hitoshi Minamiguchi, Koichiro Sonoda, Masahiro Ogawa, Takeshi Ideguchi, Yoshihisa Kizaki, Toshihiro Nakamura, Kageyuki Oba, Satoshi Higa, Keiki Yoshida, Keishiro Yagyu, Taro Miyamoto, Yasunobu Yamagishi, Hisaharu OheRitsuko Kohno, Masaharu Kataoka, Yutaka Otsuji, Haruhiko Abe

Research output: Contribution to journalArticlepeer-review

Abstract

Background: An implantable cardioverter defibrillator (ICD) is the most reliable therapeutic device for preventing sudden cardiac death in patients with sustained ventricular tachycardia (VT). Regarding its effectiveness, targeted VT is defined based on the tachyarrhythmia cycle length. However, variations in RR interval variability of VTs may occur. Few studies have reported on VT characteristics and effects of ICD therapy according to the RR interval variability. We aimed to identify the clinical characteristics of VTs and ICD therapy effects according to the RR interval variability. Methods: We analyzed 821 VT episodes in 69 patients with ICDs or cardiac resynchronization therapy defibrillators. VTs were classified as irregular when the difference between two successive beats was >20 ms in at least one of 10 RR intervals; otherwise, they were classified as regular. We evaluated successful termination using anti-tachycardia pacing (ATP)/shock therapy, spontaneous termination, and acceleration between regular and irregular VTs. The RR interval variability reproducibility rates were evaluated. Results: Regular VT was significantly more successfully terminated than irregular VT by ATP. No significant difference was found in shock therapy or VT acceleration between the regular and irregular VTs. Spontaneous termination occurred significantly more often in irregular than in regular VT cases. The reproducibility rates of RR interval variability in each episode and in all episodes were 89% and 73%, respectively. Conclusions: ATP therapy showed greater effectiveness for regular than for irregular VT. Spontaneous termination was more common in irregular than in regular VT. RR interval variability of VTs seems to be reproducible.

Original languageEnglish
Journaljournal of arrhythmia
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • RR interval variability
  • anti-tachycardia pacing therapy
  • implantable cardioverter defibrillator
  • shock therapy
  • ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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