Reactive ATP Feature and Clinical Data

Atrial Fibrillation can spontaneously organize to atrial flutter or sinus tachycardia. Reactive ATP™ (rATP) provides an opportunity to terminate an ongoing AF episode by delivering atrial antitachycardia pacing (ATP) during those times when the rhythm has organized and/or slowed. The rATP algorithm is available on current Medtronic dual chamber pacemakers and ICDs, as well as CRT devices.

WHAT EVIDENCE HAS PREVIOUSLY BEEN GENERATED ON THE EFFICACY OF REACTIVE ATP?

The randomized, controlled MINERVA trial evaluated the effects of rATP in dual chamber pacemaker patients (n = 1,166). All patients had a documented history of AT/AF within 12 months prior to enrollment.

  • Key finding: rATP + MVP™ + Atrial Intervention was associated with a 48% relative risk reduction in progression to persistent or permanent AF over 2 years.2
  • Secondary finding: rATP + MVP + Atrial Intervention was associated with a 52% reduction in AF-related hospitalizations and ER visits.

WHAT IS THE NEW EVIDENCE ON REACTIVE ATP?

An analysis of 8,032 U.S. patients in the Medtronic CareLink™ database assessed the impact of rATP across pacemakers, ICDs and CRT devices.1

  • Key finding: rATP was associated with a reduction in the progression of AF (≥ 1 day, ≥7 days, and ≥ 30days) across all device types (p < 0.001). 
  • This retrospective analysis is the first to demonstrate rATP’s benefit across device types, and in a real-world setting.
† Model components included group, age, sex, baseline AF, and device type.Frailty model results were consistent with those from Cox proportional hazard models (P > 0.0001 for all).
1 Hudnall H. Reactive Atrial-based Antitachycardia Pacing Therapy to Slow Progression of Atrial Fibrillation. August 2017, Medtronic data on file. 

 

 

This study builds upon the MINERVA trial, the first randomized, controlled study of atrial intervention pacing, atrial antitachycardia pacing (Reactive ATP) and managed ventricular pacing (MVP). The study found that in pacemaker patients with bradycardia and atrial tachyarrhythmias, the combination of those therapies significantly slowed AF disease progression over a 2 year period. Furthermore, it showed that the combination of therapies significantly reduced AF-related hospitalizations, emergency department visits and cardioversions, resulting in payer cost savings.

 

Reactive ATP: New Data Demonstrates Benefit Across IPG, ICD, and CRT Devices (PDF)

References

1 Late-breaking clinical trial, presented at EuroPace June 18, 2017.
2 Padeletti L, Pürerfellner H, Mont L, et al. New-generation atrial antitachycardia pacing (Reactive ATP) is associated with reduced risk of persistent or permanent atrial fibrillation in patients with bradycardia: Results from the MINERVA randomized multicenter international trial. Heart Rhythm. August 2015;12(8):1717-1725.

Last updated: 
12 Oct 2017