Therapeutic Research

Abstract

Background: Reactive ATPTM（R–ATP） in CIEDs has been reported to be useful forAT/AF. In this report, we describe a case in which R–ATP was effective in the treatment of repeated AT/AF after ablation. Case: A 70–years –old male patient with a history of two ablations for AT/AF and CRT–D implantation due to decreased cardiac function and wide QRS findings. Reactive ATP was introduced. The patient underwent 3rd ABL for persistent AT/AF in the same year. The following year, AT/AF recurred and 4th ABL was performed. Results: We compared R–ATP activity during 96 days from the introduction of R–ATP before performing 3rd ABL （pre 3rd ABL） and 375 days after performing 3rd ABL（post 3rd ABL）. The success rate of R –ATP was higher in post 3rd ABL than in pre 3rd ABL. 　Conclusion: If the tachycardia cycle of AT/AF is less than 210 ms or irregular, the usefulness of R –ATP is reported to be low. In a subanalysis of the MINERVA study, the efficacy of R –ATP was reported to be higher with longer and more regular cycles. It is thought that the success rate of R –ATP was improved by obtaining a longer cycle.