Fritz W. Horlbeck: ed. This article has been cited by other articles in PMC. Abstract Implantable cardioverter-defibrillators are complex technical devices with a multitude of programming options for the physician. In recent years, numerous randomized trials have been performed to define the optimal programming strategies and have provided valuable insights, especially in primary prevention patients. This article provides an actual overview on the existing evidence on the most important programming features for accurate detection and therapy of ventricular arrhythmias.
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Patients in the conventional arm had two detection zones: one at bpm for ventricular tachycardia VT with a 2. Therapy could be either antitachycardia pacing ATP or shock in all devices sequentially. Baseline characteristics were fairly similar between the three arms.
High-rate therapy vs. All-cause mortality was significantly reduced in the high-rate therapy arm 3. The incidence of first syncope was similar 4. Delayed therapy vs. All-cause mortality was numerically lower in the delayed therapy arm 4.
There was also a reduction in appropriate therapies suggesting that a lot of slower VTs are self-limiting without an increase in adverse clinical outcomes. In fact, all-cause mortality was reduced with high-dose therapy as compared with conventional programming. These results are hypothesis generating and need further study.
The majority of literature on inappropriate ICD therapy has been about the high morbidity associated with inappropriate shocks. The current trial suggests that ATP may also be associated with adverse clinical outcomes in these patients, and raises the question of whether routine ATP settings are necessary in all patients. Reduction in inappropriate therapy and mortality through ICD programming.
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Multicenter Automatic Defibrillator Implantation Trial–Reduce Inappropriate Therapy - MADIT-RIT
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Programming implantable cardioverter/defibrillators and outcomes