Predictors and Proarrhythmic Consequences of Inappropriate Implantable Cardioverter-Defibrillator Therapy

Ventricular fibrillation induced by high-output ICD shock: report of cases and review of literature

“…ICD therapies can be classified as being ‘appropriate’ or ‘inappropriate.’ Inappropriate therapies are those that are delivered in response to a rhythm other than rapid ventricular tachyarrhythmia, most commonly due to a malidentification of the rhythm and have a well-documented proarrhythmic potential 14. Appropriate therapies are delivered when ventricular tachyarrhythmias are sensed correctly and are treated according to the programmed parameters.…”

Influence of myopotential interference on the Wavelet discrimination algorithm in implantable cardioverter‐defibrillator

“…In most cases, the VF zone detected ventricular events faster than 185–200 beats/min, while the VT zone detected ventricular events faster than 150–170 beats/min. In cases of patients with documented slow VT, the detection zone lower than 150 beats/min was sometimes programmed [6].…”

“…Inappropriate ICD shocks, most frequently caused by supraventricular tachyarrhythmias [5,6], are not rare [5–8], despite effective device‐related discrimination methods such as dual‐chamber ICDs [9,10] and the stability/sudden‐onset detection [11,12]. Since inappropriate shocks could result in poorer quality of life [13,14], proarrhythmia [15–17], and increased mortality, [5,7] improvements in tachyarrhythmia detection algorithms in ICD devices are required.…”

Relation between total shock energy and mortality in patients with implantable cardioverter-defibrillator

“…Details of device programing had been described previously [9]. Ventricular Tenma et al, Page 5 fibrillation (VF) zone detected ventricular events faster than 185 -200 beats / min, and an initial therapy was 30 joule or more (maximum energy of the device).…”

“…In contrast, as a history of atrial fibrillation is one of the major causes for inappropriate shocks [6,7,9], the shock episode would have been recurrent, thereby resulting in high accumulation of the shocks and worse outcomes. Aktas et al also reported that increasing number of ICD shocks during defibrillation threshold (DFT) testing was not associated with increased risk for heart failure or death in the sub-analysis of MADIT-CRT [14].…”