Single-brand dual-chamber discriminators to prevent inappropriate shocks in patients implanted with prophylactic implantable cardioverter defibrillators: a propensity-weighted comparison of single- and dual-chamber devices

Figuero, S Briongos; Sánchez, Ana M.; Perez, M L; Martínez-Ferrer, José; García, Enrique; Viñolas, Xavier; Arenal, Ángel; Alzueta, Javier; Basterra, Nuria; Rodríguez, Aníbal; Lozano, Ignacio Fernández; Muñoz‐Aguilera, Roberto

doi:10.1007/s10840-018-0494-0

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…Propensity-score matched analysis of registry data in primary prevention ICD recipients has also suggested that dual-chamber devices have a lower rate of inappropriate shock compared with single-chamber devices. [ 23 ] In that analysis, independent predictors of inappropriate shock included a history of AF, chronic kidney disease and non-ischaemic cardiomyopathy, while PR Logic was the only discriminator that was related to a lower risk of inappropriate shock along with an SVT rate limit programmed to >200 BPM. [ 23 ]…”

Section: Dual-chamber Discriminatorsmentioning

confidence: 99%

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Successful Identification of and Discrimination Between Atrial and Ventricular Arrhythmia with the Aid of Pacing and Defibrillator Devices

Mukherjee

Sohal

Shanmugam

et al. 2021

Arrhythm Electrophysiol Rev

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The presence of supraventricular tachycardia is the leading cause of inappropriate shock in ICD recipients, and it can be a significant cause of morbidity, psychological distress and worsened clinical outcome. Modern pacing and ICD systems offer a number of discriminators that are integrated into algorithms to differentiate sustained ventricular tachycardia from supraventricular tachycardia. These algorithms can be adapted and optimised for each individual patient to ensure that only those arrhythmias that need treatment through the use of an ICD, are actually treated. This review summarises the single- and dual-chamber discriminators that can be used in the detection and classification of tachyarrhythmias.

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Section: Dual-chamber Discriminatorsmentioning

confidence: 99%

“…[ 23 ] In that analysis, independent predictors of inappropriate shock included a history of AF, chronic kidney disease and non-ischaemic cardiomyopathy, while PR Logic was the only discriminator that was related to a lower risk of inappropriate shock along with an SVT rate limit programmed to >200 BPM. [ 23 ]…”

Section: Dual-chamber Discriminatorsmentioning

confidence: 99%

Successful Identification of and Discrimination Between Atrial and Ventricular Arrhythmia with the Aid of Pacing and Defibrillator Devices

Mukherjee

Sohal

Shanmugam

et al. 2021

Arrhythm Electrophysiol Rev

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show abstract

“…Also, morphology as a single discriminator has limited sensitivity for appropriate diagnosis of ventricular arrhythmias [66]. Similar to pacemakers, dual-chamber devices are associated with improved detection of AHRE as well as with fewer inappropriate shocks [9,24].…”

Section: Implantable Cardioverterdefibrillatorsmentioning

confidence: 99%

Over- and undersensing—pitfalls of arrhythmia detection with implantable devices and wearables

Sperzel

Hamm

Hain

2020

Herzschr Elektrophys

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Long‐Term Outcomes Among a Nationwide Cohort of Patients Using an Implantable Cardioverter‐Defibrillator: UMBRELLA Study Final Results

Figuero

García‐Alberola

Rubio

et al. 2021

JAHA

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Background Large‐scale studies describing modern populations using an implantable cardioverter‐defibrillator (ICD) are lacking. We aimed to analyze the incidence of arrhythmia, device interventions, and mortality in a broad spectrum of real‐world ICD patients with different heart disorders. Methods and Results The UMBRELLA study is a prospective, multicenter, nationwide study of contemporary patients using an ICD followed up by remote monitoring, with a blinded review of arrhythmic episodes. From November 2005 to November 2017, 4296 patients were followed up. After 46.6±27.3 months, 16 067 episodes of sustained ventricular arrhythmia occurred in 1344 patients (31.3%). Appropriate ICD therapy occurred in 27.3% of study population. Patients with ischemic cardiomyopathy (hazard ratio [HR], 1.51; 95% CI, 1.29–1.78), dilated cardiomyopathy (HR, 1.28; 95% CI, 1.07–1.53), and valvular heart disease (HR, 1.94; 95% CI, 1.43–2.62) exhibited a higher risk of appropriate ICD therapies, whereas patients with hypertrophic cardiomyopathy (HR, 0.72; 95% CI, 0.54–0.96) and Brugada syndrome (HR, 0.25; 95% CI, 0.14–0.45) showed a lower risk. All‐cause death was 13.4% at follow‐up. Ischemic cardiomyopathy (HR, 3.09; 95% CI, 2.58–5.90), dilated cardiomyopathy (HR, 3.33; 95% CI, 2.18–5.10), and valvular heart disease (HR, 3.97; 95% CI, 2.25–6.99) had the worst prognoses. Delayed high‐rate detection was enabled in 39.7% of patients, and single‐zone programming occurred in 52.6% of primary prevention patients. Both parameters correlated with lower risk of first appropriate ICD therapy, with no excess risk of mortality. The rate of inappropriate shocks at follow‐up was low (6%) and did not differ among type of ICD but was lower in SmartShock‐capable devices. Conclusions Irrespective of the cause, contemporary ICD patients with heart failure–related disorders had a similar risk of ICD life‐saving interventions and death. Current ICD programming recommendations still need to be implemented. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NTC01561144.

show abstract

Single-brand dual-chamber discriminators to prevent inappropriate shocks in patients implanted with prophylactic implantable cardioverter defibrillators: a propensity-weighted comparison of single- and dual-chamber devices

Cited by 3 publications

References 27 publications

Successful Identification of and Discrimination Between Atrial and Ventricular Arrhythmia with the Aid of Pacing and Defibrillator Devices

Successful Identification of and Discrimination Between Atrial and Ventricular Arrhythmia with the Aid of Pacing and Defibrillator Devices

Over- and undersensing—pitfalls of arrhythmia detection with implantable devices and wearables

Long‐Term Outcomes Among a Nationwide Cohort of Patients Using an Implantable Cardioverter‐Defibrillator: UMBRELLA Study Final Results

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