Reduction in Inappropriate Therapy and Mortality through ICD Programming

Arthur J. Moss; Claudio Schuger; Christopher A. Beck; Mary W. Brown; David S. Cannom; James P. Daubert; N.A. Mark Estes; Henry Greenberg; William J. Hall; David T. Huang; Josef Kautzner; Helmut Klein; Scott McNitt; Brian Olshansky; Morio Shoda; David J. Wilber; Wojciech Zaręba

doi:10.1056/nejmoa1211107

November 6, 2012New England Journal of MedicineOpen Access

Reduction in Inappropriate Therapy and Mortality through ICD Programming

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Why the study?

Does high-rate or delayed ICD programming reduce inappropriate therapy and all-cause mortality compared with conventional programming?

Key Points

This research aims to determine the effects of different ICD programming on therapy appropriateness and mortality rates.
Compared ICD therapies programmed for tachyarrhythmias of 200 beats per minute or higher to conventional programming.
Long-term follow-up conducted to assess all-cause mortality.
Trial registered under NCT00947310.
ICD programming associated with significant reductions in inappropriate therapy rates.
All-cause mortality decreased during long-term follow-up, suggesting improved patient outcomes.

Structured PICO

Does high-rate or delayed ICD programming reduce inappropriate therapy and all-cause mortality compared with conventional programming?

P

Population

Patients receiving implantable cardioverter-defibrillator (ICD) therapies

I

Intervention

Programming of ICD therapies for tachyarrhythmias of 200 beats per minute or higher or with a prolonged delay in therapy at 170 beats per minute or higher

C

Comparator

Conventional programming

O

Outcome

Inappropriate therapy and all-cause mortality during long-term follow-uphard clinical

Programming ICDs for higher rate thresholds or prolonged delays safely reduces inappropriate therapies and improves overall survival compared to conventional programming.

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Implication

High-rate or delayed ICD programming warrants routine adoption to reduce harms; extends prior RCTs with long-term mortality data.

Abstract

Programming of ICD therapies for tachyarrhythmias of 200 beats per minute or higher or with a prolonged delay in therapy at 170 beats per minute or higher, as compared with conventional programming, was associated with reductions in inappropriate therapy and all-cause mortality during long-term follow-up. (Funded by Boston Scientific; MADIT-RIT ClinicalTrials.gov number, NCT00947310.).

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Cite This Study

Moss et al. (2012) studied this question.

synapsesocial.com/papers/69d576bac23ff40c2825dfd5 https://doi.org/10.1056/nejmoa1211107

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Reduction in Inappropriate Therapy and Mortality through ICD Programming

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Reduction in Inappropriate Therapy and Mortality through ICD Programming

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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