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.

THE REACTIVE ATRIAL-BASED ANTITACHYCARDIA PACING THERAPY REDUCES ATRIAL TACHYARRHYTHMIAS CLNICAL TRIAL CONFIRMED MINERVA FINDINGS.

The purpose of the study was to evaluate the effects of Reactive ATP in reducing the progression of AT/AF in pacemakers, ICDs, and CRT devices.

Analysis Design

  • N = 8,032 

  • Retrospective CareLink™ analysis

 

1Crossley GH, Padeletti L, Zweibel S, Hudnall JH, Zhang Y, Boriani G. Reactive atrial‐based antitachycardia pacing therapy reduces atrial tachyarrhythmias. PACE. 2019:42(7):970-979.

THE REAL-WORLD ANALYSIS SHOWED THAT THE REACTIVE ATP™ ALGORITHM PROVIDED A 36% RELATIVE REUDCTION IN PROGRESSION TO PERSISTENT AF.1

Reactive ATP reduces the duration of AT/AF1:

  • ≥ 1 day by 19%
  • ≥ 7 days by 36%
  • ≥ 30 days by 44%

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.

 

References

1 ​Crossley GH, Padeletti L, Zweibel S, Hudnall JH, Zhang Y, Boriani G. Reactive atrial‐based antitachycardia pacing therapy reduces atrial tachyarrhythmias. PACE. 2019:42(7):970-979.
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: 
23 Oct 2020