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ICD programming.

Mauro Biffi1

  • 1Institute of Cardiology, Policlinico S. Orsola-Malpighi, University of Bologna, Italy.

Indian Heart Journal
|February 27, 2014
PubMed
Summary
This summary is machine-generated.

Optimizing implantable cardioverter-defibrillator (ICD) programming is crucial for patient outcomes. Evidence-based, tailored ICD settings reduce inappropriate shocks and improve therapy effectiveness.

Keywords:
Arrhythmia detectionArrhythmia discriminationICD programmingVF/VT treatment

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Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Inappropriate shocks from implantable cardioverter-defibrillators (ICDs) are linked to adverse patient outcomes.
  • Optimal ICD programming is essential for preventing these shocks.

Purpose of the Study:

  • To review current literature on ICD therapy.
  • To establish evidence-based ICD programming guidelines for a wide patient population, including those with cardiac resynchronization therapy-defibrillators (CRT-D).

Main Methods:

  • Comprehensive literature review focusing on ICD therapy and programming strategies.
  • Analysis of data from large-scale ICD trials.

Main Results:

  • Recommended ventricular fibrillation (VF) detection times: 9-12 seconds.
  • Recommended ventricular tachycardia (VT) detection times: 15-60 seconds.
  • Recommended discriminator setting: up to 200 bpm.
  • Antitachycardia pacing (ATP) for VTs up to 250 bpm has a 70% success rate.
  • Target for inappropriate shock rate: less than 3.6%.

Conclusions:

  • Tailored ICD programming, based on robust clinical trial evidence, enhances patient care.
  • Utilizing pre-defined, downloadable ICD settings at implantation minimizes programming errors and ensures optimal device function.