Abstract 17758: Anti-Tachycardia Pacing Has Minimal Impact on Daily Activities Compared to Shocks
Introduction: Implantable Cardioverter Defibrillators (ICDs) can deliver either anti-tachycardia pacing (ATP) or shocks to terminate life-threatening ventricular arrhythmias. Multiple studies have shown the negative psychological consequences of multiple shocks as measured through quality of life (QOL) questionnaires. Current ICDs measure and store minutes of daily activity which we hypothesized may be sensitive to ICD therapies and, thus, a possible surrogate for QOL. Our goal was to compare the impact of ATP and shocks on patient (pt) activity.
Methods: We performed a retrospective analysis using 900 pts from the EMPIRIC study to determine the change in weekly hours of activity from pre (baseline) to post ICD therapy for shocks and ATP. Patients with an ICD therapy were separated into two groups based on their initial therapies (shock with or without ATP, ATP-only). We calculated the change in activity from cumulative activity 1 week pre-therapy to 1 week post-therapy. The activity change was compared for one, few (2-4) and many (≥5) therapies.
Results: There were 67 pts with shocks (1 - 13 / pt) and 99 pts with ATP-only (1 to 45 sequences / pt). Activity changed by a median -0.5 weekly hours (range: -41 to 14 hours) for pts with at least 1 shock compared to a median change of +0.1 weekly hours (range: -17 to 14 hours) for patients with ATP-only. Patients receiving ATP-only had a non-significant change in activity (figure). Patients receiving at least 1 shock had a significant activity change for few (p=0.02) and many therapies (p=0.01). Increasing the number of ATP sequences did not significantly impact pt activity (p=0.77). Increasing the number of shocks significantly decreased pt activity (p<0.001).
Conclusions: Patients who received ATP-only therapies had minimal impact on activity while shocked pts had temporal declines in activity. These findings suggest that patient activity may be sensitive to ICD therapies. Further analysis with a larger database is required.
- © 2013 by American Heart Association, Inc.