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Programming implantable cardioverter-defibrillator in primary prevention: Guideline concordance and outcomes.

PMID: 32058014 (view PubMed database entry)
DOI: 10.1016/j.hrthm.2020.02.004 (read at publisher's website )

Teetouch Ananwattanasuk, Tanyanan Tanawuttiwat, Ronpichai Chokesuwattanaskul, Sangeeta Lathkar-Pradhan, Waseem Barham, Hakan Oral, Ranjan K Thakur, Krit Jongnarangsin,

<h4>Background</h4>Inappropriate therapy is a common adverse effect in patients with an implantable cardioverter-defibrillator (ICD) that may be prevented by appropriate programming.<h4>Objective</h4>The purpose of this study was to assess the outcomes of device programming based on a 2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement and a 2019 focused update on optimal ICD programming and testing.<h4>Methods</h4>Consecutive patients who underwent ICD insertion for primary prevention from 2014-2016 at 3 centers were included in the retrospective analysis. Patients were classified into 2 groups based on the tachycardia programming at the time of implant: guideline concordant group (GC) and non-guideline concordant group (NGC). Kaplan-Meier analysis and Cox proportional hazard models were used to estimate freedom from ICD therapy (antitachycardia pacing or shock), ICD shock, and death.<h4>Results</h4>A total of 772 patients were included in the study (mean age 63.3 ± 13.8 years). Of this total, 258 patients (33.4%) were in the GC group and 514 patients (66.6%) were in the NGC group. During mean follow-up of 2.02 ± 0.91 years, guideline concordant programming was associated with a 53% reduction in ICD therapy (P <.01) and 50% reduction in ICD shock (P = .02). There were no significant differences in mortality (6% in GC group vs11% in NGC group; P = .22).<h4>Conclusion</h4>Only one-third of the studied population had an ICD device programmed in concordance with current guidelines. ICD programming based on the current guidelines was associated with a significantly lower rate of ICD therapy and shock without changes in mortality during intermediate-term follow-up.

Heart Rhythm (Heart rhythm)
[2020, 17(7):1101-1106]

Cited: 1 time

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