Why the study?
Does high-rate implantable cardioverter-defibrillator programming reduce antitachycardia pacing or shocks in patients with ICDs or CRT-Ds?
Does high-rate implantable cardioverter-defibrillator programming reduce antitachycardia pacing or shocks in patients with ICDs or CRT-Ds?
Adherence to evidence-based high-rate ICD programming in real-world practice significantly reduces the delivery of pacing and shock therapies, though overall adoption remains modest.
May support high-rate ICD programming to reduce therapies in practice; extends observational data but leaves open randomized confirmation.
Implantable cardioverter-defibrillator programming in Italy shifted toward evidence-based high-rate detection strategies after 2020, closely following manufacturer updates to nominal device settings, although overall adoption remained modest, reaching 15% by 2023. Programming consistent with the high-rate strategy was associated with significantly fewer therapies, including both antitachycardia pacing and shocks, confirming in real-world practice the benefits previously demonstrated in randomized trials and registries. Reprogramming during follow-up was rare, indicating that initial programming choices largely persisted over time and highlighting the need for more systematic use of remote monitoring to promote guidelinedirected optimization.
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Perrotta et al. (2026) studied this question.
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