Reactive ATP Algorithm Cardiac Device Features

Overview

Atrial Fibrillation (AF) can spontaneously organize to slower and/or more organized atrial rhythms. The Reactive ATP (rATP) algorithm delivers atrial antitachycardia pacing (ATP) to terminate an ongoing atrial fibrillation (AF) episode after a programmed interval or when the rhythm organizes and/or slows.


brady-hcp-reactive-atp-image

MINERVA Study1*

MINERVA study design graph
Study Design
  • Control DDDR (Standard Pacemaker)
  • MVP™ + aATP + Atrial Intervention Features
  • MVP
48% relative reduction in AF episodes > 7 days and 52% relative reduction in AF-related hospitalizations and ER visits

Results1

aATP + atrial intervention + MVP arm compared to control arm


*

The Reactive ATP algorithm studied in the MINERVA trial is available in our dual chamber pacemakers and ICDs, as well as our CRT-Ds and CRT-Ps.

Reactive ATP was referred to as 'aATP' in the MINERVA trial


REACTIVE ATP reduces progression of AF
ACROSS PACEMAKERS, ICDS, AND CRT DEVICES2

  • An analysis of 8,032 patients in the Medtronic CareLink™ database assessed the impact of rATP across pacemakers, ICDs, and CRT devices.
  • Key finding: rATP was associated with a reduction in the progression of AF (≥ 1 day, ≥ 7 days, and ≥ 30 days) across all device types (p < 0.001).
  • This retrospective analysis is the first to demonstrate rATP’s benefit across device types, and in areal-world setting.

RISK OF AT/AF BETWEEN MATCHED PATIENT GROUPS

micra-risk-af-at-between-matched-groups table

Model components included group, age, sex, baseline AF, and device type. Frailty model results were consistent with those from Cox proportional hazard models (P< 0.0001 for all).


40% reduced risk of persistent af
With reactive atp2

/incidence-of-at-af graph

Turning on REACTIVE ATP

Follow these steps to turn Reactive ATP on in pacemaker, implantable cardioverter defibrillator (ICD), and cardiac resynchronization therapy (CRT) devices after lead maturation.

Turning on Reactive ATP
  • AT/AF detection is nominally set to Monitor to ensure the atrial lead has matured (approximately one month after implant) before the therapy is enabled.
  • Review the Clinician Manual for information on treating AT/AF episodes with ATP therapies and detailed instructions on the programming options for scheduling atrial therapy.

1

Boriani G, Manolis AS, Tukkie R, et al. Effects of enhanced pacing modalities on health care resource utilization and costs in bradycardia patients: An analysis of the randomized MINERVA trial. Heart Rhythm. June 2015;12(6):1192-1200.

2

Hudnall H. Reactive Atrial-based Antitachycardia Pacing Therapy to Slow Progression of Atrial Fibrillation. August 2017, Medtronic data on file. Manuscript in preparation.