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KMID : 1011920200210010004
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International Journal of Arrhythmia
2020 Volume.21 No. 1 p.4 ~ p.4
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Clinical impact of applying strategic programming in patients with implantable cardioverter-defibrillators beyond reducing inappropriate shocks
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Hwang You-Mi
Kim Jun
Nam Gi-Byoung
Choi Kee-Joon
Kim You-Ho
Park Seo-Young
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Abstract
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Background: The incidence of inappropriate shocks remains high at 30% in patients with implantable cardioverter-defibrillators (ICDs). This retrospective study sought to examine the efficacy of strategic programming (ICD programming with a long detection interval and high-rate cutoff) in reducing electrical storm, inappropriate shocks, and unexpected hospital visits in patients with ICDs with/without cardiac resynchronization therapy with defibrillator (CRT-Ds).
Methods: This was a single tertiary center retrospective study, evaluating the clinical outcomes, especially regarding inappropriate therapies in patients with ICDs or CRT-Ds. Enrolled patients underwent ICD or CRT-D implantations from January 2008 to May 2016. Clinical information was attained by a thorough chart review.
Results: We analyzed 155 defibrillator patients from January 2008 to May 2016 (124 patients had ICDs and 31 had CRT-Ds). Since we adopted this strategic programming as a default programming from 2015 implanted ICDs and CRT-Ds, we divided the patients into two groups: devices implanted before 2015 (group A, n?=?94) versus implanted after 2015 (group B, n?=?61). During a median of 1289 days of follow-up, electrical storms occurred in three patients (eight events) in group B versus 11 (28 events) in group A (P?=?0.18); appropriate therapies were delivered in 27 patients (56 events) in group A versus 7 (15 events) in group B (P?=?0.72); inappropriate therapies were delivered in 15 patients (21 events) in group A versus 1 with 1 episode in group B (P?=?0.03); and 5 unexpected hospitalizations occurred in four patients in group B versus 36 in 24 patients in group A (P?=?0.02).
Conclusion: The clinical application of strategic programming reduced inappropriate shocks and unexpected hospitalizations in ICD and CRT-D patients.
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KEYWORD
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Defibrillators, Implantable, Cardiac resynchronization therapy devices, Tachycardia, Ventricular, Ventricular fibrillation
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