Schober, Alexander Daniel and Schober, Andreas Leonhard and Hubauer, Ute and Fredersdorf, Sabine and Seegers, Joachim and Keyser, Andreas and Stadler, Stefan and Birner, Christoph and Maier, Lars and Jungbauer, Carsten and Ucer, Ekrem (2021) Novel Implantable Cardioverter Defibrillator Programming With High Rate Cut-Off, Long Detection Intervals and Multiple Anti-Tachycardia Pacing Reduces Mortality. CIRCULATION JOURNAL, 85 (3). pp. 291-299. ISSN 1346-9843, 1347-4820
Full text not available from this repository. (Request a copy)Abstract
Background: Implantable cardioverter defibrillator (ICD) therapies, even when appropriate, are associated with increased risk. Therapy-reducing strategies have been shown to reduce the mortality rate. Methods and Results: In total, 895 patients with ICD and cardiac resynchronization therapy with defibrillation function (CRT-D) were included in the study; of these, 506 (57%) patients undergoing secondary prevention were included. Devices implanted before May 2014 were programmed according to conventional programming (CP), the others according to our novel programming (NP) with high rate cut-off, longer detection intervals and 4-6 anti-tachycardia pacing (ATP) trains in the ventricular tachycardia (VT) zone. Time-to-first-event for mortality, appropriate and inappropriate therapies were analyzed. Follow-up time was 24.0 months (IQR 13.0-24.0 months). There was a significant reduction in mortality rate (11.4% vs. 25.4%, P<0.001) and in the rate of appropriate (18.8% vs. 42.2%, P<0.001) and inappropriate therapies (5.2% vs. 18.0%, P<0.001) with NP according to Kaplan-Meier analyses. In multivariate analysis, NP (hazard ratio [HR]=0.35; P<0.001), chronic kidney disease (HR=1.55), reduced ejection fraction (EF) (HR=1.35), secondary ICD indication (HR=2.35) and age at implantation (HR=1.02) were associated with mortality reduction. NP was also associated with significant reduction in the rate of appropriate and inappropriate therapies. These results were consistent after stratification for primary and secondary prevention. Conclusions: Novel ICD programming reduced mortality and morbidity due to appropriate or inappropriate ICD therapies in secondary as well as in primary ICD indication.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CARDIAC-RESYNCHRONIZATION THERAPY; RAPID VENTRICULAR-TACHYCARDIA; ANTIARRHYTHMIC-DRUG THERAPY; PRIMARY PREVENTION; RANDOMIZED-TRIAL; ICD; SURVIVAL; SHOCKS; REDUCTION; ENALAPRIL; Defibrillator; Mortality; Novel; Programming |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Sep 2022 14:10 |
| Last Modified: | 06 Sep 2022 14:10 |
| URI: | https://pred.uni-regensburg.de/id/eprint/46745 |
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