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Jawaid A, Chokshi M, Zareba W, Schuger C, Daubert J, McNitt S, Singh J, Goldenberg I, Kutyifa V. Effect of Novel Programming on Inappropriate Implantable Cardioverter-Defibrillator Therapy in Patients With Very Low Ejection Fraction (from A MADIT-RIT). Am J Cardiol 2022; 182:32-39. [PMID: 36075757 DOI: 10.1016/j.amjcard.2022.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/23/2022] [Accepted: 07/05/2022] [Indexed: 11/19/2022]
Abstract
The Multicenter Automatic Defibrillator Implantation Trial - Reduce Inappropriate Therapy showed a significant reduction in the risk of inappropriate therapy in patients with a programmed high-rate cutoff ≥200 beats per minute or delayed therapy for events ≥170 beats per minute compared with conventional programming. We aimed to characterize outcomes by left ventricular ejection fraction (LVEF) ranges for patients with high-rate, delayed, or conventional implantable cardioverter-defibrillator programming. We assessed the effect of LVEF (LVEF <15%, LVEF 15% to 25%, LVEF >25%) on the risk of inappropriate conventional implantable cardioverter-defibrillator therapy and death in Multicenter Automatic Defibrillator Implantation Trial - Reduce Inappropriate Therapy. Inappropriate therapies and death were independently evaluated by the adjudication committee. Statistical methods involved Kaplan-Meier time-to-event graphs and Cox proportional hazards regression analyses. The study involved 140 patients (9%) with LVEF 15%, 585 with LVEF 15% to 25% (39%), and 774 with LVEF >25% (52%). High-rate or delayed programming significantly reduced the risk of inappropriate therapy compared with conventional programming in patients with all LVEFs (p <0.001 for all LVEF). Patients with LVEF <15% had an exceptional 97% lower risk of inappropriate therapy, with high-rate programming than conventional programming (hazard ratio 0.028, p = 0.001), without an increase in mortality. High-rate and delayed programming is superior to conventional programming in all LVEF ranges, without adverse effects.
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Affiliation(s)
- Anas Jawaid
- Clinical Cardiovascular Research Center, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Moulin Chokshi
- Clinical Cardiovascular Research Center, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Wojciech Zareba
- Clinical Cardiovascular Research Center, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Claudio Schuger
- Clinical Cardiovascular Research Center, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - James Daubert
- Clinical Cardiovascular Research Center, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Scott McNitt
- Clinical Cardiovascular Research Center, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Jagmeet Singh
- Clinical Cardiovascular Research Center, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Ilan Goldenberg
- Clinical Cardiovascular Research Center, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Valentina Kutyifa
- Clinical Cardiovascular Research Center, Department of Medicine, University of Rochester Medical Center, Rochester, New York.
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Yamamoto M, Okajima K, Shimane A, Ozawa T, Morishima I, Asai T, Takagi M, Kasai A, Fujii E, Kiyono K, Watanabe E, Ozaki Y. A Decision Tree-Based Survival Analysis of Patients with a History of Inappropriate Implantable Cardioverter-Defibrillator Therapy. Int Heart J 2019; 60:318-326. [DOI: 10.1536/ihj.18-288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Masaru Yamamoto
- Department of Laboratory Medicine, Fujita Health University Hospital
| | | | - Akira Shimane
- Department of Cardiology, Himeji Cardiovascular Center
| | - Tomoya Ozawa
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science
| | | | - Toru Asai
- Department of Cardiology, Ichinomiya Municipal Hospital
| | - Masahiko Takagi
- Division of Cardiac Arrhythmia, Cardiovascular Center, Department of Medicine II, Kansai Medical University
| | | | - Eitaro Fujii
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Ken Kiyono
- Division of Bioengineering, Graduate School of Engineering Science, Osaka University
| | - Eiichi Watanabe
- Department of Cardiology, Fujita Health University School of Medicine
| | - Yukio Ozaki
- Department of Cardiology, Fujita Health University School of Medicine
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How the S-ICD (subcutaneous implantable cardiac defibrillator) senses cardiac signals to minimize cardiac over-sensing and maximize rhythm discrimination. J Electrocardiol 2018; 51:S38-S43. [DOI: 10.1016/j.jelectrocard.2018.08.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/27/2018] [Accepted: 08/15/2018] [Indexed: 11/18/2022]
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Lund LH, Køber L, Swedberg K, Ruschitzka F. The year in cardiology 2017: heart failure. Eur Heart J 2018; 39:832-839. [DOI: 10.1093/eurheartj/ehx782] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 12/18/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
- Lars H Lund
- FoU Tema Hjärta Kärl, Norrbacka, S1: 02, 17176 Stockholm, Sweden
- Department of Medicine, Karolinska Institutet, Heart and Vascular Theme, Karolinska University Hospital, Stockholm, 171776 Stockholm, Sweden
| | - Lars Køber
- Department of Cardiology, Rigshospitalet, University of Copenhagen, København Ø, Denmark
| | - Karl Swedberg
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, 405 30 Gothenburg, Sweden
- National Heart and Lung Institute, Imperial College, London SW7 2AZ, UK
| | - Frank Ruschitzka
- University Heart Centre Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
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