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ICD Programming to Reduce Shocks and Improve Outcomes

  • Invasive Electrophysiology and Pacing (EK Heist, Section Editor)
  • Published:
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Abstract

Despite the clinical benefit of implantable cardioverter defibrillator (ICD), there is a high frequency of inappropriate ICD therapy associated with impaired quality of life, unwanted health care resource utilization, and adverse clinical outcome. Alternative strategies of ICD programming are needed to reduce the risk of inappropriate and “unnecessary” ICD therapies and to improve patient outcome. In this review, we provide an overview of the rate of inappropriate and appropriate ICD therapies in clinical trials and large registries as well as a review of current trials evaluating novel ICD programming to reduce inappropriate ICD therapy to avoid unnecessary ICD therapy. Based on recent studies including a large randomized trial, we recommend a simple programming approach involving high-rate device therapy beginning at 200 bpm with a 2.5 sec delay for it reduces inappropriate therapy, unnecessary therapy, and all-cause mortality in patients receiving ICD or CRT-D devices for primary prevention indications.

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Conflict of Interest

Institutional research support from Boston Scientific, St. Paul, Minnesota to the University of Rochester Medical Center for MADIT-related ICD trials.

Valentina Kutyifa, Wojciech Zareba, and Arthur J. Moss declare that they have no other conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Heart Research Follow-Up Program, University of Rochester Medical Center, Rochester, NY, USA

    Valentina Kutyifa, Wojciech Zareba & Arthur J. Moss

  2. Heart Research Follow-up Program, Cardiology Division, University of Rochester Medical Center, 265 Crittenden Blvd., Box 653, Rochester, NY, 14642, USA

    Valentina Kutyifa

Authors
  1. Valentina Kutyifa
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  2. Wojciech Zareba
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  3. Arthur J. Moss
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Corresponding author

Correspondence to Valentina Kutyifa.

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This article is part of the Topical Collection on Invasive Electrophysiology and Pacing

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Kutyifa, V., Zareba, W. & Moss, A.J. ICD Programming to Reduce Shocks and Improve Outcomes. Curr Cardiol Rep 16, 496 (2014). https://doi.org/10.1007/s11886-014-0496-1

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  • DOI: https://doi.org/10.1007/s11886-014-0496-1

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