Author + information
- Richard Z. Andraws, MD∗ ()
- ↵∗Gagnon Cardiovascular Institute at Atlantic Health and Central New Jersey Cardiology, 1511 Park Avenue, Suite 2, South Plainfield, New Jersey 07080
The paper by Chen et al. (1) on the relevance of rapid rate nonsustained ventricular tachycardia (RR-NSVT) noted on routine defibrillator follow-up is intriguing. Figure 3 in the article demonstrated an inappropriate shock for an episode of RR-NSVT that self-terminated but for which the device was “committed” to delivering therapy. A question for the authors is what role did such shocks play in their finding of increased mortality with these episodes? They note that nearly 5% of patients received inappropriate therapy. Did the mortality results change significantly if patients were stratified by shock appropriateness? This is particularly relevant in light of the dramatic findings of the MADIT-RIT (Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy) trial (2) and could provide further evidence that a minimalist approach to defibrillator therapy is best for patient outcomes.
- American College of Cardiology Foundation