ADVANCE CRT - D: Antitachycardia Pacing (ATP) Delivery for Painless Implantable Cardioverter Defibrillator (ICD) Therapy
ADVANCE CRT - D: Antitachycardia Pacing (ATP) Delivery for Painless Implantable Cardioverter Defibrillator (ICD) Therapy
To compare the efficacy of RV and BiV ATP for the termination of ventricular arrhythmias in
 patients who are candidates to a cardiac resynchronisation therapy (CRT) and have a Class I
 or IIA indication for ICD implantation.

 The hypothesis of delivering ATP from different sites (RV or BIV) has never been evaluated in
 a prospective, controlled and randomized study.
Main objective: Compare efficacy of ATP therapy (Burst, 8 pulses, 88 %, 1 sequence) to
 terminate all types of ventricular tachycardia (all VTs (FVT+VT)) when delivered in the right
 ventricle (RV) only versus both ventricles (BiV) resulting in a 10 % difference in favour of
 BIV ATP

 Secondary objectives:

 -  Compare efficacy of the first BiV and RV ATP (Burst, 8 pulses, 88 %) to terminate fast
 ventricular tachycardia (FVT)

 -  Compare efficacy of the first BiV and RV ATP (Burst, 8 pulses, 88 %) to terminate slow
 ventricular tachycardia (slow VT)

 -  Compare efficacy of BiV and RV ATP (all ATP therapies) to terminate slow ventricular
 tachycardia (slow VT)

 -  Determine the rate of both FVT and VT episodes which are accelerated or degenerates into
 VF
Inclusion Criteria:

 -  CRT + ICD indications (Class I-IIA) according to the guidelines

 -  Patients have been implanted with a Medtronic Marquis Family ICD capable of RV-ATP or
 BIV-ATP

 -  Patients in chronic AF who undergo a complete AV ablation and that the complete AV
 block is confirmed at PHD

 Exclusion Criteria:

 -  Patient's life expectancy less than 1 year due to a non cardiac chronic disease

 -  Patient on heart transplant list which is expected in < 1 year

 -  Patient's age less than 18 years

 -  Replacements and upgrades

 -  Epicardial lead

 -  Mechanical tricuspid valve

 -  Ventricular Tachyarrhythmias associated with reversible causes

 -  Unwillingness or inability to provide written informed consent

 -  Enrollment in, or intention to participate in, another clinical study during the
 course of this study

 -  Inaccessibility for follow-up at the study center