2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

Wilkoff, Bruce L.; Fauchier, Laurent; Stiles, Martin K.; Morillo, Carlos A.; Al‐Khatib, Sana M.; Almendral, Jesús; Aguinaga, Luis; Berger, Ronald D.; Cuesta, Alejandro; Daubert, James P.; Dubner, Sérgio; Ellenbogen, Kenneth A.; Estes, N.A. Mark; Fenelon, Guilherme; García, Fermin C.; Gasparini, Maurizio; Haines, David E.; Healey, Jeff S.; Hurtwitz, Jodie L.; Keegan, Roberto; Kolb, Christof; Kuck, Karl‐Heinz; Marinskis, Germanas; Filho, Martino Martinelli; McGuire, Mark A.; Molina, L; Okumura, Ken; Proclemer, Alessandro; Russo, Andrea M.; Singh, Jagmeet P.; Swerdlow, Charles D.; Teo, Wee Siong; Uribe, William; Viskin, Sami; Wang, Chun‐Chieh; Zhang, Shu

doi:10.1016/j.hrthm.2015.11.018

Cited by 236 publications

(168 citation statements)

References 222 publications

(214 reference statements)

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“…11 The US Food and Drug Administration approved the S-ICD based on a series of single-armed clinical studies that demonstrated acceptably low rates of complications and successful conversion of ventricular tachyarrhythmias. 12,13 Current guidelines 14 recommend defibrillation threshold (DFT) testing at the time of S-ICD implantation, based on concerns regarding increased defibrillation energy requirements (compared to TV-ICDs) and the absence of evidence suggesting that it is safe to forgo DFT testing. To our knowledge, there are currently no data describing early use of the S-ICD across the United States.…”

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confidence: 99%

Trends and In-Hospital Outcomes Associated With Adoption of the Subcutaneous Implantable Cardioverter Defibrillator in the United States

et al. 2016

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IMPORTANCE Trends and in-hospital outcomes associated with early adoption of the subcutaneous implantable cardioverter defibrillator (S-ICD) in the United States have not been described. OBJECTIVES To describe early use of the S-ICD in the United States and to compare in-hospital outcomes among patients undergoing S-ICD vs transvenous (TV)-ICD implantation. DESIGN, SETTING, AND PARTICIPANTS A retrospective analysis of 393 734 ICD implants reported to the National Cardiovascular Data Registry ICD Registry, a nationally representative US ICD registry, between September 28, 2012 (US Food and Drug Administration S-ICD approval date), and March 31, 2015, was conducted. A 1:1:1 propensity-matched analysis of 5760 patients was performed to compare in-hospital outcomes among patients with S-ICD with those of patients with single-chamber (SC)–ICD and dual-chamber (DC)–ICD. MAIN OUTCOMES AND MEASURES Analysis of trends in S-ICD adoption as a function of total ICD implants and comparison of in-hospital outcomes (death, complications, and defibrillation threshold [DFT] testing) among S-ICD and TV-ICD recipients. RESULTS Of the 393 734 ICD implants evaluated during the study period, 3717 were S-ICDs (0.9%). A total of 109 445 (27.8%) of the patients were female; the mean (SD) age was 67.03 (13.10) years. Use of ICDs increased from 0.2%during the fourth quarter of 2012 to 1.9% during the first quarter of 2015. Compared with SC-ICD and DC-ICD recipients, those with S-ICDs were more often younger, female, black, undergoing dialysis, and had experienced prior cardiac arrest. Among 2791 patients with S-ICD who underwent DFT testing, 2588 (92.7%), 2629 (94.2%), 2635 (94.4%), and 2784 (99.7%) were successfully defibrillated (≤65, ≤70, ≤75, and≤80 J, respectively). In the propensity-matched analysis of 5760 patients, in-hospital complication rates associated with S-ICDs (0.9%) were comparable to those of SC-ICDs (0.6%) (P = .27) and DC-ICD rates (1.5%) (P = .11). Mean (SD) length of stay after S-ICD implantation was comparable to that after SC-ICD implantation (1.1 [1.5] vs 1.0 [1.2] days; P = .77) and less than after DC-ICD implantation (1.1 [1.5] vs 1.2 [1.5] days; P < .001). CONCLUSIONS AND RELEVANCE The use of S-ICDs is rapidly increasing in the United States. Early adoption has been associated with low complication rates and high rates of successful DFT testing despite frequent use in patients with a high number of comorbidities.

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Trends and In-Hospital Outcomes Associated With Adoption of the Subcutaneous Implantable Cardioverter Defibrillator in the United States

et al. 2016

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“…We first searched for potential differences in normalised VF amplitude distribution using 7 mV as reference, since it represents the amplitude recommended at implantation 11. Then, we further quantified VF amplitude distribution using subgroups of BR R-wave amplitude at ≈5 mV intervals (≥2.2 to <7 mV; ≥7 to <12; ≥12 to <17; ≥17; see online supplementary table S2).…”

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confidence: 99%

Safety threshold of R-wave amplitudes in patients with implantable cardioverter defibrillator

Lillo-Castellano

Marina-Breysse

Gómez-Gallanti

et al. 2016

Heart

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“…ATP is a safe, effective and painless therapy for VTs with large clinical evidence supporting its routine use in primary and secondary ICD patients[31,32]. …”

Section: Conclusion and “Take Home Messages”mentioning

confidence: 99%

“…In a recent expert consensus document on ICD programming, from the most important world leading arryhthmological societies[32], it was stated that “in all patients with structural heart disease... that ATP therapy be active for all ventricular tachyarrhythmia detection zones to include arrhythmias up to 230 bpm, to reduce total shocks except when ATP is documented to be ineffective or proarrhythmic”.…”

Section: Conclusion and “Take Home Messages”mentioning

confidence: 99%

Antitachycardia pacing programming in implantable cardioverter defibrillator: A systematic review

Maria¹,

Giacopelli²,

Borghi³

et al. 2017

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Implantable cardioverter defibrillator (ICD) programming involves several parameters. In recent years antitachycardia pacing (ATP) has gained an increasing importance in the treatment of ventricular arrhythmias, whether slow or fast. It reduces the number of unnecessary and inappropriate shocks and improves both patient’s quality of life and device longevity. There is no clear indication regarding the type of ATP to be used, except for the treatment of fast ventricular tachycardias (188 bpm-250 bpm) where it has been shown a greater efficacy and safety of burst compared to ramp; 8 impulses in each sequence of ATP appears to be the best programming option in this setting. Beyond ATP use, excellent clinical results were obtained with programming standardization following these principles: extended detection time in ventricular fibrillation (VF) zone; supraventricular discrimination criteria up to 200 bpm; first shock in VF zone at the maximum energy in order to reduce the risk of multiple shocks. The MADIT-RIT trial and some observational registries have also recently demonstrated that programming with a widespread use of ATP, higher cut-off rates or delayed intervention reduces the number of inappropriate and unnecessary therapies and improves the survival of patients during mid-term follow-up.

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2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

Cited by 236 publications

References 222 publications

Trends and In-Hospital Outcomes Associated With Adoption of the Subcutaneous Implantable Cardioverter Defibrillator in the United States

Trends and In-Hospital Outcomes Associated With Adoption of the Subcutaneous Implantable Cardioverter Defibrillator in the United States

Safety threshold of R-wave amplitudes in patients with implantable cardioverter defibrillator

Antitachycardia pacing programming in implantable cardioverter defibrillator: A systematic review

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