Prevention of Inappropriate Shocks in ICD Recipients: A Review of 10,000 Tachycardia Episodes

Anselme, Frédéric; Mletzko, R.; Bowes, Robert; Mabo, Philippe; Sadoul, Nicolas; Schoels, Wolfgang; Seidl, Karlheinz; Schwab, Joerg O.; Iscolo, N.; Nitzsche, R.

doi:10.1111/j.1540-8159.2007.00622.x

Cited by 16 publications

(21 citation statements)

References 14 publications

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“…With single-chamber discriminators, under-detection occurs in 0-0.4% of VT episodes with stability [44,48], 0-2% with morphology [49], and 0.5-5% with onset criteria [44]. For dual-chamber devices, VT underdetection has been reported in 0.6-1% of events [45,50,51].…”

Section: Svt Discriminatorsmentioning

confidence: 92%

Recommendations for the Programming of Implantable Cardioverter-Defibrillators in New Zealand

Webber

Stiles

2012

Heart, Lung and Circulation

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Section: Svt Discriminatorsmentioning

confidence: 92%

Recommendations for the Programming of Implantable Cardioverter-Defibrillators in New Zealand

Webber

Stiles

2012

Heart, Lung and Circulation

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“…Five of the studies reviewed compared sotalol with placebo or b-blocker. 14,15 Studies are ongoing. Of note, in the Pacifico study, only 28% of the group randomized to placebo received b-blockers, which may have influenced the results in favor of sotalol.…”

Section: Sotalol In Heart Failure Patientsmentioning

confidence: 99%

Sotalol as Adjunctive Therapy to Implantable Cardioverter‐Defibrillators in Heart Failure Patients

Chaki

Caines

Miller

2009

Congestive Heart Failure

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The number of heart failure patients with implantable cardioverter-defibrillators is rising. Common issues encountered in this population are high defibrillation thresholds and inappropriate shocks. In order to resolve these problems, the addition of a class III antiarrhythmic such as sotalol is often considered. Given the emerging issue of polypharmacy and medication compliance in the heart failure population, the question of the efficacy of sotalol in reducing inappropriate shocks, defibrillation thresholds, and its ability to replace conventional beta-blockers is often raised. Current literature review suggests that sotalol is a useful adjunct to the contemporary heart failure regimen. It has the ability to reduce inappropriate shocks and defibrillation thresholds, but appears not to fully reproduce the pleiotropic beneficial effects of the beta-blockers more commonly employed for their mortality/remodeling benefits in heart failure patients.

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“…If a rhythm is classifi ed as unstable, it is diagnosed as AF and no therapy is delivered; if it is stable with AV dissociation, it is treated as VT and therapy is delivered. However, if there is AV association, the algorithm classifi es the arrhythmia as an SVT and no therapy is delivered [ 3 ]. • Because supraventricular arrhythmias are the most common cause of inappropriate therapy, controversy remains over whether a dual-chamber device with more complex detection algorithms is better than a singlechamber device in discriminating between SVT and true VT.…”

Section: Minimizing Shocks In Inappropriate Therapymentioning

confidence: 99%

Optimal programming of ICDs for prevention of appropriate and inappropriate shocks

Al‐Ahmad²,

Hsia³

et al. 2008

Curr Treat Options Cardio Med

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Expansion of indications for implantable cardioverter-defibrillators (ICDs) has led to a significant increase in the number of patients receiving ICDs and the number of lives saved because of ICD therapy. However, appropriate or inappropriate shocks are frequent and may result in a significant decrease in quality of life in patients with ICDs. Atrial fibrillation with rapid ventricular response, sinus tachycardia, atrial tachycardia or atrial flutter with rapid conduction, and other supraventricular tachycardias are the most common arrhythmias causing inappropriate therapy. Other causes include oversensing of diaphragmatic potentials or myopotentials, T-wave oversensing, double or triple counting of intracardiac signals, lead fractures or header connection problems, lead chatter or noise, and electromagnetic interference. Strategies to reduce inappropriate therapy using device programming rely on the ability to distinguish supraventricular and atrial arrhythmias from ventricular tachycardia. Avoiding therapy for nonsustained ventricular arrhythmias and increasing the role of antitachycardia pacing to terminate ventricular tachycardia are key approaches to reducing shocks for ventricular arrhythmias. Optimal programming holds great promise for decreasing the overall incidence of shock therapy and increasing ICD acceptance.

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Prevention of Inappropriate Shocks in ICD Recipients: A Review of 10,000 Tachycardia Episodes

Abstract: In this conventional ICD population, the overall specificity of standard dual-chamber arrhythmia detection settings reached 94%. This feature allows efficient detection of fast as well as slow VT events with a very low rate of inappropriate shocks.

Cited by 16 publications

References 14 publications

Recommendations for the Programming of Implantable Cardioverter-Defibrillators in New Zealand

Recommendations for the Programming of Implantable Cardioverter-Defibrillators in New Zealand

Sotalol as Adjunctive Therapy to Implantable Cardioverter‐Defibrillators in Heart Failure Patients

Optimal programming of ICDs for prevention of appropriate and inappropriate shocks

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