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.
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.
Perrotta et al. (Thu,) studied this question.