Author + information
- Serkan Çay1,
- Fatih Uçar1,
- Göksel Çağırcı2,
- Serkan Topaloğlu1,
- Dursun Aras1,
- Fırat Özcan1,
- Özcan Özeke1,
- Muhammet Cebeci1 and
- Sinan Aydoğdu1
Inappropriate shock is frequently encountered clinical problem despite advance technologies to detect and treat the arrhythmia in most modern ICDs.
The aim is to evaluate whether simply programming the device zones can effectively increase appropriate shocks and decrease inappropriate shocks.
All-comers (n=122) with an indication for an ICD device (ICD + CRT-ICD) for primary prevention were included in the study. Two groups were formed according to programmed therapy zones. Conventional group (n=79) had 3 zones as VT1 (167-182 bpm with ATP + shock), VT2 (182-200 bpm with ATP + shock) and VF (>200 bpm with shock). Study group (n=43) had also 3 zones as VT1 (171-200 bpm with ATP + shock), VT2 (200-230 bpm with ATP and shock) and VF (>230 bpm with shock). All participants were followed-up for 6-month. The primary objectives were first episode of appropriate and inappropriate therapies.
The mean age was 56±12 years with male ratio of 88% and 66% had ischemic origin, 53% had hypertension, 18% had diabetes, and 19% had atrial fibrillation. ICD was present in 80% and 20% had CRT-ICD device. The mean left ventricular EF was 26%±5. The primary objective of first episode of appropriate shock was higher in the study group compared with the conventional group (16.3% vs. 5.1%, p=0.043). The other primary objective of first episode of inappropriate shock was lower in the study group compared with the conventional group (0% vs. 8.9%, p=0.045) (Figure).
Increased therapy zones were related with %9 absolute reduction in first inappropriate shock.