It is possible to program the current ICD to deliver a train of ATP to an arrhythmia detected in the VF zone.

It is possible to program the current ICD to deliver a train of ATP to an arrhythmia detected in the VF zone.

• A. False
• B. Not possible
• C. Only with confirmation ON
• D. True

Answer: (D)

Anti-tachy pacing can be used not only for slower ventricular tachycardias but also within the fastest detection zone of an ICD. Many modern devices allow you to program a train of ATP even when the rhythm falls into the ventricular fibrillation (VF) detection zone. The idea is to try overdrive pacing to interrupt a fast, VT-like tachycardia that sits in that zone, potentially reducing the need for a shock. Of course, if the rhythm is actually true VF, ATP is unlikely to terminate it and the device will typically proceed to shock as the definitive therapy. So it is possible to program ATP to deliver in the VF zone, though the clinical usefulness depends on the nature of the rhythm and device settings.

Anti-tachy pacing can be used not only for slower ventricular tachycardias but also within the fastest detection zone of an ICD. Many modern devices allow you to program a train of ATP even when the rhythm falls into the ventricular fibrillation (VF) detection zone. The idea is to try overdrive pacing to interrupt a fast, VT-like tachycardia that sits in that zone, potentially reducing the need for a shock. Of course, if the rhythm is actually true VF, ATP is unlikely to terminate it and the device will typically proceed to shock as the definitive therapy. So it is possible to program ATP to deliver in the VF zone, though the clinical usefulness depends on the nature of the rhythm and device settings.