Programming an ICD to a lower limit of VT detection at 128 beats/min yielded similar sensitivity (98.8% vs 100%) and specificity (94.4% vs 89%) compared to 153 beats/min (NS).
RCT (n=90)
randomized
Does programming an ICD to a lower limit of VT detection at 128 beats/min compared to 153 beats/min improve the specificity and sensitivity of slow VT discrimination in patients with ventricular tachyarrhythmias?
Programming a long Tachy detection interval (128 beats/min) in dual chamber ICDs maintains high sensitivity and specificity for slow VT discrimination without significant risk of inappropriate interventions.
p-value: p=NS
New developments in dual chamber implantable cardioverter defibrillators (ICD) have increased the specificity of therapy delivery. This study was performed to examine the performance of an algorithm, focusing on its ability to distinguish slow ventricular tachycardia (VT) from sinus rhythm or supraventricular tachyarrhythmias. The patient population included 77 men and 13 women, 63 +/- 11 years old, treated with ICDs after episodes of spontaneous or inducible ventricular tachyarrhythmias. They were randomized to programming of the ICD to a lower limit of VT detection at 128 beats/min (group I, n = 44), versus 153 beats/min II (group II, n = 46). The primary endpoint of the study consisted of comparing the specificity and sensitivity of the algorithm between the two groups of patients. Over a 10.1 +/- 3.5 months follow-up, 325 episodes were detected in the Tachy zone in group I, versus 106 in group II. The sensitivity and specificity of the algorithm in group I were 98.8% and 94.4%, respectively, versus 100% and 89% in group II (NS). A single episode of VT at a rate of 132 beats/min was diagnosed as SVT in group I. The sensitivity and specificity of the algorithm for tachycardias <153 beats/min were 97.4% and 94.5%, respectively. Overall VT therapy efficacy was 100% in both groups. The performance of this algorithm in the slow VT zone supports the programming of a long Tachy detection interval to document slow events, and allows to treat slow VT, if necessary, without significant risk of inappropriate interventions for sinus tachycardia.
Mletzko et al. (Mon,) conducted a rct in Ventricular tachyarrhythmias (n=90). ICD programmed to lower limit of VT detection at 128 beats/min vs. ICD programmed to lower limit of VT detection at 153 beats/min was evaluated on Specificity and sensitivity of the algorithm to distinguish slow VT from sinus rhythm or SVT (p=NS). Programming an ICD to a lower limit of VT detection at 128 beats/min yielded similar sensitivity (98.8% vs 100%) and specificity (94.4% vs 89%) compared to 153 beats/min (NS).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: