First inappropriate implantable cardioverter defibrillator therapy is often due to inaccurate device programming: analysis of the French OPERA registry

Leenhardt, Antoine; Defaye, Pascal; Mouton, Elisabeth; Delay, Marc; Delarche, Nicolas; Dupuis, Jean‐Marc; Bizeau, Olivier; Mabo, Philippe; Cheggour, S.; Babuty, Dominique

doi:10.1093/europace/eus144

Cited by 12 publications

(10 citation statements)

References 30 publications

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“…In the ASSERT study, including patients with dual chamber pacemakers, it was demonstrated that subclinical AF of ≥ 6 min duration was associated with 2.5-fold higher risk of stroke and systemic thromboembolism [23]. AF remains also the main cause of inappropriate therapies of ICDs [7,8]. Proper AS plays a crucial role in both arrhythmia discrimination and supraventricular arrhythmia diagnostics.…”

Section: Discussionmentioning

confidence: 99%

“…Two models of ICDs were implanted, i.e. Lumax 540 VR-T DX (patients [1][2][3][4][5][6][7][8][9][10][11][12][13][14] and Iforia 5 VR-T DX (patients [15][16][17][18][19][20][21][22][23][24], due to changes with time in models availability in our center.…”

Section: Icd Implantationmentioning

confidence: 99%

“…Prevalence of supraventricular tachyarrhythmias, mainly atrial fibrillation (AF), is higher among patients with HF and is associated with greater morbidity and mortality [5,6]. AF is also one of the most frequent causes of inappropriate therapy in patients with ICDs [7,8]. Most patients enrolled into ICD studies were implanted with single-lead devices [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Influence of echocardiographic and radiographic characteristics on atrial sensing amplitude in patients with Linox Smart S DX defibrillation leads

et al. 2017

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(PP, periprocedural), predischarge (IHFU, in-hospital follow-up) (3.15 vs. 1.2 mV, p = 0.045, 7.53 vs. 3.8 mV, p < 0.001 and 5.63 vs. 2.44 mV, p = 0.017 for PP measurements, IHFU and AFU, respectively). There was a significant negative correlation between AS-PP and short RA dimension (RADs) (r = -0.56, p = 0.02), AS-IHFU and RA area (RAA) (r = -0.45, p < 0.05), AS-AFU and long RA dimension (RADl) (r = -0.46; p = 0.02), 48, p = 0.02), p < 0.01). There was no relationship between AS and other right heart dimensions. Conclusions: Larger RA size and low sensing dipole location were associated with lower AS amplitude in single-lead dual chamber ICD. (Cardiol J 2017; 24, 6: 671-676) and 3-6 months after the procedure (AFU, ambulatory follow-up). Results were related to atrial dipole position in the right atrium (RA) on the basis of chest X-ray examination as well as right heart dimensions at echocardiography. Results: Twenty-four patients were included into final analysis. In 14 (58.3%) patients, sensing dipole was located in regions 1 and 2 of the RA. AS amplitude was greater in regions 1 and 2 when compared to other locations

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Section: Discussionmentioning

confidence: 99%

Section: Icd Implantationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Influence of echocardiographic and radiographic characteristics on atrial sensing amplitude in patients with Linox Smart S DX defibrillation leads

et al. 2017

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“…However, inappropriate therapies, most commonly caused by supraventricular tachyarrhythmias (SVTs), remain a significant adverse effect of ICD therapy, affecting up to 40% of patients during long-term follow-up (6)(7)(8)(9)(10). Besides the pain and discomfort caused by inappropriate shocks, they are also associated with anxiety, depression, impaired quality of life, proarrhythmia, low treatment satisfaction, and possibly mortality (11)(12)(13).…”

mentioning

confidence: 99%

Reduced Risk for Inappropriate Implantable Cardioverter-Defibrillator Shocks With Dual-Chamber Therapy Compared With Single-Chamber Therapy

Kolb

Sturmer

Sick³

et al. 2014

JACC: Heart Failure

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Therapy with dual-chamber settings for ICD discrimination combined with algorithms for minimizing ventricular pacing was associated with reduced risk for inappropriate shock compared with single-chamber settings, without increases in mortality and morbidity. (Optimal Anti-Tachycardia Therapy in Implantable Cardioverter-Defibrillator [ICD] Patients Without Pacing Indications [OPTION]; NCT00729703).

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“…In einer Studie von 2012 war ein aktiviertes "Time out"-Kriterium, welches nach einer programmierbaren Tachykardiedauer (üblich 3-5 min) unabhängig vom Ergebnis der SVT-Diskriminatoren eine ICD-Intervention erzwingt, für 18 % aller inadäqua-ten Schockabgaben verantwortlich [14].…”

Section: Detektionsgrenze ▼unclassified

Prognostische Implikation und Strategien zur Vermeidung von ICD-Schocks

Horlbeck

Nickenig

Schwab

2014

Dtsch med Wochenschr

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Klinische Relevanz ▼ ImplantierbareCardioverter/Defibrillatoren (ICD) verhindern wirksam den plötzlichen Herztod. Sie sind aber mit dem Risiko inadäquater Schockabgaben, meist verursacht durch supraventrikuläre Herzrhythmusstörungen (SVT), behaftet. Diese sind, neben den unmittelbaren Schmerzen und der erhöhten Rate an Hospitalisierungen, oft auch mit einer durch vermehrte Angst und Depression reduzierten Lebensqualität verbunden [2,15]. Bemerkenswerterweise sind darüber hinaus inadäquate ebenso wie adäquate Schockabgaben mit einer signifikant erhöhten Mortalität assoziiert [17,19,22,27,29].Zwei aktuelle prospektive randomisierte Studien (MADIT-RIT, PROVIDE) zeigten insbesondere die Reduktion inadäquater Schockabgaben durch optimierte ICD-Programmierung. Hier fand sich über-raschenderweise auch eine signifikante Reduktion der Mortalität [17,22]. Bereits anhand der MADIT-II-Daten war die Assoziation von inadäquaten ICDSchockabgaben mit erhöhter Mortalität diskutiert worden [3,20]. Der Zusammenhang adäquater Schockabgaben mit einer erhöhten Mortalität ist bekannt und lässt sich durch eine mit einem Progress der kardialen Grunderkrankung einhergehende erhöhte Rate an ventrikulären Arrhythmien erklären [19]. Die Deutung im Falle inadäquater Schockabgaben erscheint allerdings komplizierter. Ein ebenfalls vermehrtes Auftreten inadäquater Schockabgaben durch häufigeres Vorhofflimmern und Sinustachykardien im Rahmen einer progredienten Herzinsuffizienz wäre eine plausible Erklä-rung. Allerdings waren lediglich adäquate und inadäquate Schockabgaben mit erhöhter Sterblichkeit assoziiert, während inadäquate antitachykarde Stimulationen (ATP) dies nicht zeigten. Eine Metaanalyse aus vier Studien (PainFREE Rx, PainFREE Rx II, EMPIRIC und PREPARE), in welchen ATP zur Reduktion von unnötigen Schockabgaben eingesetzt wurden, verglich den Effekt verschiedener Arten elektrischer Therapien: adäquate Schockabgaben, nicht jedoch adäquate Überstimulationen waren mit erhöhter Mortalität assoziiert (qAbb.

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First inappropriate implantable cardioverter defibrillator therapy is often due to inaccurate device programming: analysis of the French OPERA registry

Abstract: First inappropriate therapy occurred in 11% of 636 ICD recipients followed for ∼2 years. Nearly 50% of FIT could have been prevented by improving device programming.

Cited by 12 publications

References 30 publications

Influence of echocardiographic and radiographic characteristics on atrial sensing amplitude in patients with Linox Smart S DX defibrillation leads

Influence of echocardiographic and radiographic characteristics on atrial sensing amplitude in patients with Linox Smart S DX defibrillation leads

Reduced Risk for Inappropriate Implantable Cardioverter-Defibrillator Shocks With Dual-Chamber Therapy Compared With Single-Chamber Therapy

Prognostische Implikation und Strategien zur Vermeidung von ICD-Schocks

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