Comparison of Inappropriate Shocks and Other Health Outcomes Between Single‐ and Dual‐Chamber Implantable Cardioverter‐Defibrillators for Primary Prevention of Sudden Cardiac Death: Results From the Cardiovascular Research Network Longitudinal Study of Implantable Cardioverter‐Defibrillators
Key result
Dual-chamber ICDs are not linked to fewer inappropriate shocks versus single-chamber devices.
- HR 0.91
- 95% CI 0.59-1.38
- P=0.65
- n=1,042
Why the study?
The superiority of dual-chamber over single-chamber ICDs in reducing inappropriate shocks in clinical practice for primary prevention of sudden cardiac death has not been established.
Does a dual-chamber ICD reduce inappropriate shocks compared to a single-chamber ICD in patients receiving an ICD for primary prevention without pacing indications?
Population
1042 patients receiving ICD for primary prevention without pacing indication from 15 US hospitals
Comparison
Dual-chamber ICD vs single-chamber ICD
Design
Cohort study with propensity score weighting
Authors
Discussion
Loading...
Member takes
Implication
No association with fewer inappropriate shocks for dual-chamber ICDs; should not yet change practice and leaves open need for randomized trials.
Study Design
Type
Cohort (n=1,042)
Multicenter
Yes
Structured PICO
Does a dual-chamber ICD reduce inappropriate shocks compared to a single-chamber ICD in patients receiving an ICD for primary prevention without pacing indications?
P
Population
1,042 patients receiving an ICD for primary prevention without an indication for pacing across 15 hospitals.
E
Exposure
Dual-chamber implantable cardioverter-defibrillator (ICD)
C
Comparator
Single-chamber implantable cardioverter-defibrillator (ICD)
O
Outcome
Time to first inappropriate shock (adjudicated for appropriateness)safety
Main Result
Hazard Ratio: 0.91 (95% CI 0.59–1.38)
p-value: p=0.65
In patients receiving an ICD for primary prevention without pacing indications, dual-chamber devices do not reduce inappropriate shocks or improve clinical outcomes compared to single-chamber devices.
Cite This Study
Peterson et al. (2017) conducted a cohort in Primary prevention of sudden cardiac death (n=1,042). Dual-chamber ICD vs. Single-chamber ICD was evaluated on Time to first inappropriate shock (HR 0.91, 95% CI 0.59-1.38, p=0.65). Dual-chamber ICDs were not associated with a lower risk of inappropriate shock compared with single-chamber devices (HR 0.91; 95% CI 0.59-1.38; P=0.65).