The REACT-ICD Trial

Launched by HARTFORD HOSPITAL · May 6, 2015

Keywords

ClinConnect Summary

Atrial tachyarrhythmias (ATA) and heart failure (HF), which are well-recognized causes of morbidity and mortality, are growing and concerning issues in our patient population. In patients implanted with a dual-chamber implantable cardioverter defibrillator (ICD), progression of paroxysmal to persistent or permanent atrial fibrillation (AF) has been documented. Because of the untoward consequences of AF, such as development/worsening of HF or thromboembolic events (stroke and myocardial infarction \[MI\]), prevention of permanent AF has the potential to improve quality of life, reduce hospit...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • male and female patients
• • ≥18 years old (no upper age limit)
• • previously implanted with a Medtronic dual-chamber or CRT ICD with capability of atrial antitachycardia pacing; specifically, Reactive ATP™ at least 9 months previously (six months data collection and implant occurring at least 3 months previously to allow healing and establishment of stable sensing)
• • measured P wave in sinus rhythm of at least 0.8 mV
• • \>=6 months AT/AF burden data available, either from CareLink® or in-office interrogation
• • \>=1.0% AT/AF burden (hours in atrial fibrillation/total hours monitored) in the last 6 months
• • No change in antiarrhythmic drug therapy (Vaughan-Williams class I or III) in the last 6 months
• Exclusion Criteria:
• • Persistent or permanent AT/AF (AF burden \>95%)
• • Cardioversion for atrial fibrillation or atrial flutter within the last 6 months, either intentional or as a result of a tachyarrhythmia therapy
• • Ablation for atrial fibrillation or atrial flutter within the last 9 months (6 months data collection following a 3 month blanking period post procedure)
• • Reactive ATP™ previously programmed on
• • Measured P waves in sinus rhythm consistently \<0.8 mV on repeat measurements.
• • Unresolved artifactual AT/AF detection due to far-field R wave or other oversensing
• • Expected generator change or other device surgery within six months