Medtronic Reactive ATP therapy slows atrial fibrillation progression in real-world population


Medtronic has announced that its Reactive atrial-based antitachycardia pacing (ATP) therapy slows the progression of atrial fibrillation (AF) in patients with implanted cardiac devices. A real-world analysis of nearly 8,800 patients was presented at EHRA EUROPACE-CARDIOSTIM 2017.

According to a company release, Reactive ATP is an advanced, painless pacing therapy found exclusively on Medtronic pacemakers, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) devices. It repeatedly sends pacing pulses to the atria during abnormally fast rhythms to restore the heart’s normal rhythm, thereby slowing the progression of AF.

The retrospective analysis assessed pacemaker, ICD and CRT device data from 8,798 patients followed by the Medtronic CareLink remote monitoring system. Reactive ATP therapy was associated with a statistically significant decrease in AF events compared to a matched control group. Most notably, the Reactive ATP patient group experienced a 38% reduction in persistent AF events (lasting greater than seven days) (p<0.0001). This benefit was observed across patient age, sex, and device type.

“Atrial fibrillation can be a debilitating disease that imposes a significant burden upon the entire healthcare community—impacting patients, caregivers, providers and costs of care—especially as the disease progresses,” says Giuseppe Boriani, professor of cardiology at the University of Modena and Reggio Emilia, Modena, Italy. “These are the first real-world data on the clinical impact of Reactive ATP therapy and the first in patients with ICDs and CRT devices. These data have important implications for all device patients because of the high prevalence of AF and the correlation of disease progression to worsened patient outcomes.”

This study builds upon the MINERVA trial, the first randomised, controlled study of Reactive ATP. It found that Reactive ATP therapy significantly slowed AF disease progression in patients with pacemakers with the therapy, compared to those without it. Furthermore, Reactive ATP significantly reduced AF-related hospitalisations, emergency department visits and cardioversions, resulting in payer cost savings.


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