Reactive ATP allows for multiple deliveries of programmed ATP therapies in response to two clinically relevant events Change in the arrhythmia rhythm cycle length or regularity Elapsed period of ID: 674458
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Slide1
Reactive ATP and MINERVASlide2Slide3
Reactive
ATP allows for multiple deliveries of programmed ATP therapies in response to two clinically relevant events:
Change in the arrhythmia
rhythm
(cycle length or regularity)Elapsed period of time
Atrial Reactive ATP OverviewSlide4
Atrial Reactive ATP Programming
Rhythm Change
options:
On/Off
Time Interval
options:
Off, 2
hrs
…48
hrsSlide5
Reactive
ATP – Rhythm Change
If Rhythm Change is enabled:
ATP Therapy “bins” are automatically created by the device based upon whether 1 or 2 zones for AT/AF detection are programmed
The full set of programmed ATP therapies (Rx1, Rx2, Rx3) is available for each bin and for each zone
Regular
Irregular
Regular
IrregularSlide6
Treated AT/AF Programmer ViewSlide7
Evolution of Reactive ATPSlide8
Example of Changing Atrial ArrhythmiasSlide9Slide10
Reactive
ATP ExampleSlide11
Another Reactive ATP ExampleSlide12
MINERVA Study
n=385
n=383
n=398Slide13
MIN
imiz
E
Right Ventricular pacing to prevent Atrial fibrillation and heart failure studyPrimary objective is to compare the Control DDDR to DDDRP+MVP arms at 2 years using the composite clinical endpoints of
All Cause Death
CV Hospitalizations
Permanent AF
MINERVASlide14Slide15Slide16
61% relative reduction between DDDRP + MVP arm and Control DDDR (p = 0.003)Slide17
Risk of AF >7 Days and
aATP
Efficacy
I
mplies
that
aATP
is a driving force behind the resultsSlide18
Primary End Point
2 year composite of death, CV hospitalizations, and permanent AF in DDDRP + MVP arm vs. Control DDDR (26% relative risk reduction, p = 0.04)
End point driven by slowing progression of AF
61% relative reduction between DDDRP + MVP arm and Control DDDR (p = 0.004)
Rates for HCU to AF (hospitalizations, ER visits, atrial CVs) lower in DDDRP + MVP arm compared to Control DDDRMINERVA Key ResultsSlide19
Pacing thresholds rise as the coupling interval is reduced
High outputs designed to maximize the ability to capture all coupling intervals during ATP
1000
aATP
per month decreases longevity by less than 3%Longevity