First multi-centre evaluation of a knowledge-based implant-assistant for implantable cardioverter-defibrillators

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
Bjoern Henrik DiemPeter Hanrath

Abstract

Modern implantable cardioverter-defibrillators (ICDs) place increasing demands on the physician, as their complexity requires more and more knowledge and effort in handling them. To overcome this problem an implant-assistant has been developed, which transfers clinical data entered by the physician into a complete set of parameters for programming a dual-chamber ICD (Tachos-DR, Biotronik, Berlin, Germany) at DFT testing (DFT-Prog) and first permanent programming (Perm-Prog) after implant. Routine ICD implantations were initially evaluated by clinical experts at 19 centres in USA and Europe from 178 patient files. The rating of parameters was related to the number of parameters available in each patient. For DFT-Prog, 98.4% of parameter suggestions were identical to experts' expectations, an additional 1.0% were accepted, 0.5% were rejected, and none was considered harmful. This resulted in an overall acceptance of 94.4% of the DFT-Prog. For Perm-Prog, 96.1% of parameters were identical to those advised by experts, an additional 2.4% were accepted, 1.5% rejected, and seven parameters (0.04%) were considered potentially harmful by experts with an overall acceptance of 86.5%. Adaptation of the implant-assistant increased the overa...Continue Reading

References

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