Anti-tachycardia pacing in ARVC: should a transvenous or subcutaneous system be used?

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Graphical Abstract

S-ICD, subcutaneous ICD; TV-ICD, transvenous implantable cardioverter defibrillator; VF, ventricular fibrillation; VT, ventricular tachycardia. Created with BioRender.com.

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Most cited references 12

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Reduction in inappropriate therapy and mortality through ICD programming.

Arthur Moss, Claudio Schuger, Christopher Beck … (2012)

The implantable cardioverter-defibrillator (ICD) is highly effective in reducing mortality among patients at risk for fatal arrhythmias, but inappropriate ICD activations are frequent, with potential adverse effects. We randomly assigned 1500 patients with a primary-prevention indication to receive an ICD with one of three programming configurations. The primary objective was to determine whether programmed high-rate therapy (with a 2.5-second delay before the initiation of therapy at a heart rate of ≥200 beats per minute) or delayed therapy (with a 60-second delay at 170 to 199 beats per minute, a 12-second delay at 200 to 249 beats per minute, and a 2.5-second delay at ≥250 beats per minute) was associated with a decrease in the number of patients with a first occurrence of inappropriate antitachycardia pacing or shocks, as compared with conventional programming (with a 2.5-second delay at 170 to 199 beats per minute and a 1.0-second delay at ≥200 beats per minute). During an average follow-up of 1.4 years, high-rate therapy and delayed ICD therapy, as compared with conventional device programming, were associated with reductions in a first occurrence of inappropriate therapy (hazard ratio with high-rate therapy vs. conventional therapy, 0.21; 95% confidence interval [CI], 0.13 to 0.34; P<0.001; hazard ratio with delayed therapy vs. conventional therapy, 0.24; 95% CI, 0.15 to 0.40; P<0.001) and reductions in all-cause mortality (hazard ratio with high-rate therapy vs. conventional therapy, 0.45; 95% CI, 0.24 to 0.85; P=0.01; hazard ratio with delayed therapy vs. conventional therapy, 0.56; 95% CI, 0.30 to 1.02; P=0.06). There were no significant differences in procedure-related adverse events among the three treatment groups. Programming of ICD therapies for tachyarrhythmias of 200 beats per minute or higher or with a prolonged delay in therapy at 170 beats per minute or higher, as compared with conventional programming, was associated with reductions in inappropriate therapy and all-cause mortality during long-term follow-up. (Funded by Boston Scientific; MADIT-RIT ClinicalTrials.gov number, NCT00947310.).

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Implantable cardioverter-defibrillator harm in young patients with inherited arrhythmia syndromes: A systematic review and meta-analysis of inappropriate shocks and complications

Louise Olde Nordkamp, Pieter Postema, Reinoud Knops … (2016)

Implantable cardioverter-defibrillators (ICDs) are implanted with the intention to prolong life in selected patients with inherited arrhythmia syndromes, but ICD implantation is also associated with inappropriate shocks and complications.

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Ventricular arrhythmias in the North American multidisciplinary study of ARVC: predictors, characteristics, and treatment.

Mark Link, Douglas Laidlaw, Bronislava Polonsky … (2014)

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with sudden cardiac death. However, the selection of patients for implanted cardioverter-defibrillators (ICDs), as well as programming of the ICD, is unclear.

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Author and article information

Contributors

Julia Cadrin-Tourigny:

ORCID: https://orcid.org/0000-0002-7489-8744

Andrew D Krahn:

ORCID: https://orcid.org/0000-0002-7982-1586

Magdi Saba:

ORCID: https://orcid.org/0000-0002-0134-4214

Journal

Journal ID (nlm-ta): Europace

Journal ID (iso-abbrev): Europace

Journal ID (publisher-id): europace

Title: Europace

Publisher: Oxford University Press (US )

ISSN (Print): 1099-5129

ISSN (Electronic): 1532-2092

Publication date Collection: May 2023

Publication date (Electronic): 22 May 2023

Publication date PMC-release: 22 May 2023

Volume: 25

Issue: 5

Electronic Location Identifier: euad132

Affiliations

Cardiovascular Genetics Center, Montreal Heart Institute, Université de Montréal , 5000 rue Bélanger, Montréal, QC, Canada H1T 1C8

Division of Cardiology, University of British Columbia , Vancouver, Canada

Cardiovascular Clinical Academic Group, St George’s University Hospitals NHS Foundation Trust , London, UK

Author notes

The opinions expressed in this article are not necessarily those of the Editors of Europace or of the European Society of Cardiology.

Conflict of interest: J.C.-T. is a consultant for Tenaya, Lexeo, Bayer, and BMS/Pfizer. M.S. receives educational grant funding from Biosense Webster, Abbott, and Boston Scientific.

Corresponding author. Tel: +1 514 376 3330; E-mail address: julia.cadrin-tourigny@ 123456icm-mhi.org

Author information

Julia Cadrin-Tourigny https://orcid.org/0000-0002-7489-8744

Andrew D Krahn https://orcid.org/0000-0002-7982-1586

Magdi Saba https://orcid.org/0000-0002-0134-4214

Article

Publisher ID: euad132

DOI: 10.1093/europace/euad132

PMC ID: 10202496

PubMed ID: 37213070

SO-VID: 74d666d5-c65b-4680-bd03-23ed3f330430

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

History

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Pages: 3

Funding

Funded by: Marvin Carsley Cardiology Research;

Funded by: Montreal Heart Institute Foundation, DOI 10.13039/501100012651;

Anti-tachycardia pacing in ARVC: should a transvenous or subcutaneous system be used?

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Most cited references 12

Reduction in inappropriate therapy and mortality through ICD programming.

Implantable cardioverter-defibrillator harm in young patients with inherited arrhythmia syndromes: A systematic review and meta-analysis of inappropriate shocks and complications

Ventricular arrhythmias in the North American multidisciplinary study of ARVC: predictors, characteristics, and treatment.

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