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Home  >  Medical Research Archives  >  Issue 149  > Programming Tachycardia Zones to Reduce Avoidable Defibrillator Shocks
Published in the Medical Research Archives
Jul 2022 Issue

Programming Tachycardia Zones to Reduce Avoidable Defibrillator Shocks

Published on Jul 31, 2022




Introduction: Most of avoidable defibrillator therapies can be reduced by evidence-based programming, but defining tachycardia configurations across all device manufacturers is not straightforward.

Aims: To determine if a uniform programming of tachycardia zones, independently of the manufacturer, result in a lower rate of avoidable shocks in primary-prevention heart failure (HF) patients and also if programming high-rate or delayed therapies can have some benefit.

Methods: Prospective cohort with historical controls. HF patients with a primary-prevention indication for a defibrillator were randomized to receive one of two new programming configurations (high-rate or delayed therapies). A historical cohort of patients with conventional programming was analyzed for comparison. The primary endpoint was any therapy [shock or anti-tachycardia pacing (ATP)] delivered. Secondary endpoints were appropriate shocks, appropriate ATP, appropriate therapies, inappropriate shocks, syncope and death.

Results: 89 patients were assigned for new programming group [high rate (n=47) or delayed therapy (n=42)]. They were compared with 94 historical patients with conventional programming. During a mean follow-up of 20±7 months, the new programming was associated with a reduction in any therapy (HR = 0.265, 95% CI 0.121-0.577, p=0.001), even after adjustment. Aproppriate ATP and any shock were also reduced. Syncope did not occur.  Sudden, cardiovascular and all-cause deaths were not different between the groups.  In the new programming group, neither highrate nor delayed programming were better than the other.

Conclusions: In our study, programming tachycardia zones homogeneously across all manufacturers was possible and resulted in a lower rate of therapies, shocks and appropriate ATP.

Author info

Rita Marinheiro, Leonor Parreira, Cláudia Lopes, Pedro Amador, Dinis Mesquita, José Farinha, Ana Esteves, Joana Ferreira, Rui Coelho, Jeni Quintal, Rui Caria

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