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Updated: Nov 5, 2025

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

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Risk factors for the first and second inappropriate implantable cardioverter-defibrillator therapy

Nobuhiro Nishii1, Takashi Noda2, Takashi Nitta3

  • 1Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.

International Journal of Cardiology. Heart & Vasculature
|May 17, 2021
PubMed

Insights

Younger age, atrial fibrillation/flutter, and specific ICD types increase the risk of the first inappropriate implantable cardioverter-defibrillator (ICD) therapy. No intervention after the first event predicts a second event.

Area of Science:

  • Cardiology
  • Medical Devices
  • Clinical Research

Background:

  • Inappropriate implantable cardioverter-defibrillator (ICD) therapy events pose risks.
  • Previous studies identified factors like atrial fibrillation/flutter (AF/AFL), younger age, and multiple ICD zones, but real-world data and risk factors for subsequent events remain unclear.

Purpose of the Study:

  • To identify risk factors for the first inappropriate ICD therapy event.
  • To examine risk factors for the second inappropriate ICD therapy event using real-world data.

Main Methods:

  • Post-hoc analysis of a multicenter, prospective observational study (Nippon Storm Study).
  • Included 1549 patients with ICD or cardiac resynchronization therapy with defibrillator (CRT-D).
  • Multivariate Cox regression analysis was used to identify risk factors.

Main Results:

  • Younger age, AF/AFL, ICD without CRT, and multiple zones were significant risk factors for the first inappropriate ICD therapy event.
  • The sole significant risk factor for a second inappropriate ICD therapy event was no intervention after the first event.

Conclusions:

  • Risk factors for the first inappropriate ICD therapy event align with prior reports.
  • Prompt intervention following a first inappropriate ICD event may mitigate the risk of subsequent events.
Abstract

Keywords:
AF/AFL, atrial fibrillation/atrial flutterATP, antitachycardia pacingCRT-D, cardiac resynchronization therapy with defibrillatorCardiac resynchronization therapy with defibrillatorICD, implantable cardioverter-defibrillatorIQR, interquartile rangeImplantable cardioverter-defibrillatorInappropriate ICD therapyLVEF, left ventricular ejection fractionNippon storm studySD, standard deviationVF, ventricular fibrillationVT, ventricular tachycardia

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