{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T05:27:07Z","timestamp":1792906027077,"version":"4.5.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Boston Scientific Corporation"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>MODULAR antitachycardia pacing (ATP), a multicenter, international trial, assesses a modular cardiac rhythm management system: a subcutaneous implantable cardioverter defibrillator in wireless communication with a leadless pacemaker (LP) capable of pace-terminating ventricular tachycardia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Enrolees had one or more clinical risk factors for ventricular tachycardia and did not require chronic pacing. Complications included prespecified major LP system- and procedure-related complications, and any complication related to the LP, subcutaneous implantable cardioverter defibrillator, implantation, or study protocol. Survival analysis was performed to identify complication-free rates, therapy delivery, and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>The 297 patients enrolled had an ejection fraction of 35\u00b113%, 43% secondary prevention indications, and 59% with prior ventricular arrhythmias. Of 286 patients undergoing LP implantation (100% success), 251 patients completed 12-month follow-up. Mortality rate was 6%, with none related to the implant procedure. Median follow-up duration was 23.4 months (interquartile range, 17.9\u201328.1). The LP major complication-free rate was 97.2%, exceeding the performance goal. The overall LP+ subcutaneous implantable cardioverter defibrillator system-related complication-free rate was 88.5%. Appropriate tachyarrhythmia-therapy (ATP+shock) rates were 14.4%, and appropriate shock rates were 8.5%. Inappropriate total tachyarrhythmia therapy was 9.5% of which 8.5% were shocks. ATP was 67.3% successful in terminating ventricular arrhythmia episodes and accelerated ventricular arrhythmias in 10.1% of episodes. Overall therapy burden (ATP+shock) was 96\/100 patient-years, of which 44\/100 patient-years was for shock delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>One-year outcomes of the first modular pacing-defibrillator system reveal low system and LP complication rates and good ATP efficacy rates, suggesting that the modular cardiac rhythm management is a viable alternative to single-chamber implantable cardioverter defibrillators using low-energy pacing capability without the need for transvenous leads.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CLINICAL TRIAL REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/\">https:\/\/clinicaltrials.gov\/<\/jats:ext-link>\n                      ; Unique identifier: NCT04798768.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.125.014395","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T18:15:17Z","timestamp":1763057717000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["One-Year Outcomes of the MODULAR ATP Trial: A Novel Leadless Pacemaker in Wireless Communication With a Subcutaneous Implantable Cardioverter Defibrillator"],"prefix":"10.1161","volume":"19","clinical-trial-number":[{"clinical-trial-number":"nct04798768","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0708-9330","authenticated-orcid":true,"given":"Michael S.","family":"Lloyd","sequence":"first","affiliation":[{"name":"Section of Cardiac Electrophysiology, Emory University, Atlanta, GA (M.S.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5638-4993","authenticated-orcid":true,"given":"Vivek Y.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology, Mount Sinai Fuster Heart Hospital, New York, NY (V.Y.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1174-6401","authenticated-orcid":true,"given":"Paul","family":"Roberts","sequence":"additional","affiliation":[{"name":"Clinical Cardiology Research, University Hospital Southampton, United Kingdom (P.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5555-7672","authenticated-orcid":true,"given":"Rahul N.","family":"Doshi","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Group and HonorHealth Research Institute, Honor Health, Scottsdale, AZ (R.N.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5783-6648","authenticated-orcid":true,"given":"David L.","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Liverpool Heart and Chest Hospital, United Kingdom (D.L.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4591-4220","authenticated-orcid":true,"given":"Lucas V.A.","family":"Boersma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Antonius Hospital, Nieuwegein, Utrecht, the Netherlands (L.V.A.B.)."},{"name":"Department of Cardiology, Amsterdam UMC, the Netherlands (L.V.A.B., R.E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5052-2948","authenticated-orcid":true,"given":"Paul A.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (P.A.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4334-8165","authenticated-orcid":true,"given":"Petr","family":"Neuzil","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Na Homolce Hospital, Prague, Czechia (P.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2806-3903","authenticated-orcid":true,"given":"Carina","family":"Blomstr\u00f6m-Lundqvist","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Medical Sciences, Faculty of Medicine and Health, \u00d6rebro University, \u00d6rsebro &amp; 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