Inappropriate ICD therapy: does device configuration make a difference.

Dwarakraj Soundarraj; Ranjan K Thakur; Joseph C Gardiner; Atul Khasnis; Krit Jongnarangsin

doi:10.1111/j.1540-8159.2006.00445.x

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Inappropriate ICD therapy: does device configuration make a difference.

Dwarakraj Soundarraj·Ranjan K Thakur·Joseph C Gardiner·Atul Khasnis·Krit Jongnarangsin

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Abstract

INTRODUCTION: Inappropriate implantable cardioverter defibrillator (ICD) therapy (IT) is a common complication in patients with ICD. IT is commonly triggered by supraventricular tachycardias (SVT). Dual chamber ICDs (D-ICDs) may distinguish SVT from ventricular tachycardia/ventricular fibrillation better than single chamber ICDs (S-ICDs) and may be associated with a smaller incidence of IT. METHODS: We reviewed the charts of 386 patients who had an ICD implanted for an AHA class I indication. Intracardiac electrograms were used to classify shocks as either appropriate or inappropriate. RESULTS: Of 295 patients with an S-ICD, 66 (22.3%) received IT, compared to 5 (5.4%) of 91 patients with a D-ICD. The likelihood of being event-free at 1, 2, 3, and 4 years was 96.1%, 96.1%, 96.1%, and 89% for patients with D-ICD and 80.7%, 72.7%, 69.6%, and 66.4%, respectively, for patients with S-ICD (P < 0.001). Multivariate analysis showed no significant association with age, sex, history of atrial fibrillation, history of hypertension, or ejection fraction. SVTs were the commonest cause of IT in our patients. CONCLUSION: Patients with D-ICD are less likely to receive IT as compared to patients with S-ICD.

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Dwarakraj Soundarraj, Ranjan K Thakur, Joseph C Gardiner, Atul Khasnis, Krit Jongnarangsin. 2006. Inappropriate ICD therapy: does device configuration make a difference.. https://doi.org/10.1111/j.1540-8159.2006.00445.x

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