TY - JOUR
T1 - Generic ICD programming and outcomes
AU - Khan, Parisha
AU - Jahagirdar, Nishat
AU - Laybourn, Micaela
AU - Harding, Idris
AU - Cannatà, Antonio
AU - Bromage, Daniel I.
AU - Shabeeh, Husain
AU - Kabunga, Peter
AU - Petzer, Edward
AU - Murgatroyd, Francis
AU - Scott, Paul A.
N1 - Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Publisher Copyright:
© 2021 Wiley Periodicals LLC
PY - 2021/12
Y1 - 2021/12
N2 - Introduction: Generic ICD programming, where shock-reduction programming is extrapolated from trials of one manufacturer to another, may reduce non-essential ICD therapies beyond that seen in randomized trials. However, the benefits and risks are unknown. The purpose of this retrospective cohort study was to evaluate the impact of a standardized programming protocol, based on generic programming, across manufacturers. Methods: We included all new ICDs in a single center (2009–2019). In 2013 a standardized programming protocol based on generic programming was introduced, incorporating high detection rates (200 bpm for primary prevention) and long detection (30/40 or equivalent in VF zone) for all patients. Patients were classified into three groups based on implant programming: pre-guideline (PS), post-guideline and guideline compliant (GC) and post-guideline but not guideline compliant (NGC). The end-points were the first occurrence of any device therapy (ATP or shock), ICD shock, syncope and all-cause mortality. Survival analysis was used to evaluate outcomes. Results: 1003 patients were included (mean follow-up 1519 ± 1005 days). In primary prevention patients (n = 583) freedom from ICD therapy (91.5% vs. 73.6%, p <.001) or shock (94.7% vs 84.8%, p =.02) were significantly higher in GC compared to PS patients, without significant increase in syncope or mortality. In secondary prevention patients (n = 420) freedom from any ICD therapy or any shock were non-significantly higher in GC compared to PS patients, without an increase in syncope or mortality. Conclusions: In primary prevention patients a standardized programming protocol, incorporating generic programming, reduced the burden of ICD therapy without an increase in adverse outcomes.
AB - Introduction: Generic ICD programming, where shock-reduction programming is extrapolated from trials of one manufacturer to another, may reduce non-essential ICD therapies beyond that seen in randomized trials. However, the benefits and risks are unknown. The purpose of this retrospective cohort study was to evaluate the impact of a standardized programming protocol, based on generic programming, across manufacturers. Methods: We included all new ICDs in a single center (2009–2019). In 2013 a standardized programming protocol based on generic programming was introduced, incorporating high detection rates (200 bpm for primary prevention) and long detection (30/40 or equivalent in VF zone) for all patients. Patients were classified into three groups based on implant programming: pre-guideline (PS), post-guideline and guideline compliant (GC) and post-guideline but not guideline compliant (NGC). The end-points were the first occurrence of any device therapy (ATP or shock), ICD shock, syncope and all-cause mortality. Survival analysis was used to evaluate outcomes. Results: 1003 patients were included (mean follow-up 1519 ± 1005 days). In primary prevention patients (n = 583) freedom from ICD therapy (91.5% vs. 73.6%, p <.001) or shock (94.7% vs 84.8%, p =.02) were significantly higher in GC compared to PS patients, without significant increase in syncope or mortality. In secondary prevention patients (n = 420) freedom from any ICD therapy or any shock were non-significantly higher in GC compared to PS patients, without an increase in syncope or mortality. Conclusions: In primary prevention patients a standardized programming protocol, incorporating generic programming, reduced the burden of ICD therapy without an increase in adverse outcomes.
KW - antitachycardia pacing
KW - implantable cardioverter-defibrillator
KW - programming
KW - shocks tachycardiac detection
KW - ventricular tachycardia
UR - http://www.scopus.com/inward/record.url?scp=85118451344&partnerID=8YFLogxK
U2 - 10.1111/pace.14386
DO - 10.1111/pace.14386
M3 - Article
AN - SCOPUS:85118451344
SN - 0147-8389
VL - 44
SP - 1995
EP - 2004
JO - PACE - Pacing and Clinical Electrophysiology
JF - PACE - Pacing and Clinical Electrophysiology
IS - 12
ER -