Programming implantable cardioverter-defibrillator therapy zones to high ranges to prevent delivery of inappropriate device therapies in patients with primary prevention: results from the RISSY-ICD (Reduction of Inappropriate ShockS bY InCreaseD zones) trial

The American Journal of Cardiology
Serkan CayDursun Aras

Abstract

Inappropriate shock is a frequently seen clinical problem despite advanced technologies used in modern implantable cardioverter-defibrillator (ICD) devices. Our aim was to investigate whether simply raising the ICD detection zones can decrease inappropriate therapies while still providing appropriate therapy. We randomized 223 patients with primary prevention to either the conventional programming group with 3 zones as VT1 (167 to 182 beats/min) with discriminators, VT2 (182 to 200 beats/min) with discriminators, and ventricular fibrillation (>200 beats/min) (n=100) or the high-zone programming group with 3 zones as VT1 (171 to 200 beats/min) with discriminators, VT2 (200 to 230 beats/min) with discriminators, and ventricular fibrillation (>230 beats/min; n=101). Twenty-two patients were lost to follow-up. The primary objectives were the first episode of appropriate and inappropriate therapies. The secondary objectives were all-cause mortality and hospitalization for heart failure. During 12-month follow-up, the first episode of appropriate therapy was higher (22% vs 10%, hazard ratio [HR] 2.18, 95% confidence interval [CI], 1.09 to 4.36, p=0.028) and the first episode of inappropriate therapy was lower (5% vs 28%, HR 0.18 [95%...Continue Reading

References

Mar 22, 2002·The New England Journal of Medicine·Arthur J MossUNKNOWN Multicenter Automatic Defibrillator Implantation Trial II Investigators
May 21, 2004·The New England Journal of Medicine·Michael R BristowUNKNOWN Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Investigators
May 21, 2004·The New England Journal of Medicine·Alan KadishUNKNOWN Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators
Sep 3, 2009·The New England Journal of Medicine·Arthur J MossUNKNOWN MADIT-CRT Trial Investigators
Feb 27, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Michael O SweeneyBruce L Wilkoff
Aug 13, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Avi FischerBruce L Wilkoff
Mar 6, 2012·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·Nicolas ClementyDominique Babuty
May 4, 2012·European Journal of Heart Failure·John G F ClelandJean-Claude Daubert
Nov 8, 2012·The New England Journal of Medicine·Arthur J MossUNKNOWN MADIT-RIT Trial Investigators
Feb 14, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Mark S KremersJohn Rumsfeld

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Citations

Apr 22, 2015·Herzschrittmachertherapie & Elektrophysiologie·Christof Kolb
Jun 9, 2016·Scandinavian Cardiovascular Journal : SCJ·Bert VandenberkRik Willems
Feb 25, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Daniel J Cantillon, Bruce L Wilkoff
Oct 11, 2017·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·Serkan CaySerkan Topaloglu

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