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Generic ICD programming and outcomes.

Parisha Khan¹, Nishat Jahagirdar¹, Micaela Laybourn¹

¹Department of Cardiology, King's College Hospital NHS Foundation Trust, London, UK.

Pacing and Clinical Electrophysiology : PACE

|October 21, 2021

Summary

This summary is machine-generated.

A standardized implantable cardioverter-defibrillator (ICD) programming protocol reduced device therapies in primary prevention patients. This approach improved outcomes without increasing adverse events like syncope or mortality.

Keywords:

antitachycardia pacing implantable cardioverter-defibrillator programming shocks tachycardiac detection ventricular tachycardia

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Published on: February 22, 2022

Area of Science:

Cardiology
Medical Devices
Clinical Trials

Background:

Generic implantable cardioverter-defibrillator (ICD) programming may reduce therapies beyond randomized trials, but risks are unknown.
Evaluating a standardized, manufacturer-agnostic programming protocol is crucial for optimizing ICD use.

Purpose of the Study:

To assess the impact of a standardized, generic programming protocol on ICD therapies and clinical outcomes.
To compare outcomes between patients programmed before and after protocol implementation.

Main Methods:

Retrospective cohort study of 1003 new ICD implants (2009-2019) at a single center.
Implementation of a standardized programming protocol in 2013 with high detection rates.
Analysis of device therapy, ICD shock, syncope, and all-cause mortality using survival analysis.

Main Results:

In primary prevention (n=583), guideline-compliant (GC) programming significantly increased freedom from ICD therapy (91.5% vs 73.6%) and shock (94.7% vs 84.8%) compared to pre-guideline (PS) patients.
No significant increase in syncope or mortality was observed in GC patients.
Secondary prevention patients showed non-significant trends towards improved therapy-free survival with GC programming.

Conclusions:

A standardized programming protocol using generic programming effectively reduced ICD therapy burden in primary prevention.
This protocol demonstrated improved efficacy without compromising patient safety, showing no increase in adverse events.