Avoid Delivering Therapies for Nonsustained Fast Ventricular Tachyarrhythmia in Patients with Implantable Cardioverter/Defibrillator: The ADVANCE III Trial

Schwab, Félix; Gasparini, Maurizio; Lunati, Maurizio; Proclemer, Alessandro; Kaup, Bernd; Santi, Elisabetta; Ligorio, G.; Klersy, Catherine; Sousa, João de; Okreglicki, A; Arenal, Ángel; Wijffels, Maurits C.E.F.; Lemke, Bernd

doi:10.1111/j.1540-8167.2008.01415.x

Cited by 22 publications

(11 citation statements)

References 13 publications

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“…Patients were randomized to the standard-detection programming used in the PainFREE II trial 14 (18/24 intervals) or to long-detection programming (30/40 intervals). 16 A VT zone was programmed when a slow VT with CL > 320 ms had previously been recorded; therapy programming was tailored by the physician to the recorded VT.…”

Section: Methodsmentioning

confidence: 99%

Different impact of long-detection interval and anti-tachycardia pacing in reducing unnecessary shocks: data from the ADVANCE III trial

et al. 2016

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AimsA long-detection interval (LDI) (30/40 intervals) has been proved to be superior to a standard-detection interval (SDI) (18/24 intervals) in terms of reducing unnecessary implantable cardioverter defibrillator (ICD) therapies. To better evaluate the different impact of LDI and anti-tachycardia pacing (ATP) on reducing painful shocks, we assessed all treated episodes in the ADVANCE III trial.Methods and resultsA total of 452 fast (200 ms < cycle length ≤ 320 ms) arrhythmic episodes were recorded: 284 in 138 patients in the SDI arm and 168 in 82 patients in the LDI arm (106/452 inappropriate detections). A total of 346 fast ventricular tachycardias (FVT) were detected in 169 patients: 208 in 105 patients with SDI and 138 in 64 patients with LDI. Setting LDI determined a significant reduction in appropriate but unnecessary therapies [208 in SDI vs. 138 in LDI; incidence rate ratio (IRR): 0.61 (95% CI 0.45–0.83), P = 0.002]. Anti-tachycardia pacing determined another 52% reduction in unnecessary shocks [208 in SDI with hypothetical shock-only programming vs. 66 in LDI with ATP; IRR: 0.37 (95% CI 0.25–0.53, P < 0.001)]. The efficacy of ATP in terminating FVT was 63% in SDI and 52% in LDI (P = 0.022). No difference in the safety profile (acceleration/degeneration and death/cardiovascular hospitalizations) was observed between the two groups.ConclusionThe combination of LDI and ATP during charging is extremely effective and significantly reduces appropriate but unnecessary therapies. The use of LDI alone yielded a 39% reduction in appropriate but unnecessary therapies; ATP on top of LDI determined another 52% reduction in unnecessary shocks. The strategy of associating ATP and LDI could be considered in the majority of ICD recipients.

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Section: Methodsmentioning

confidence: 99%

Different impact of long-detection interval and anti-tachycardia pacing in reducing unnecessary shocks: data from the ADVANCE III trial

et al. 2016

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“…By prolonging the time of detection to longer settings, it is not surprising that fewer inappropriate therapies were delivered; previous studies have shown that most inappropriate therapies are determined by high-rate conducted atrial arrhythmias or lead noises, both of which are influenced favorably by a longer NID. [7][8][9][10][11][12][13][14][15][16] Nevertheless, in terms of the recent hypothesis of a possible association between unnecessary ATPs and increased risk of adverse events in PP, the present data provide a clear indication for a programming strategy that can safely reduce inappropriate therapies in SP patients as well.…”

Section: Inappropriate Therapiesmentioning

confidence: 95%

“…11 Continuous data were described as means and SDs, whereas categorical data were expressed as counts and percentages. Follow-up duration was reported as median and 25th to 75th percentiles.…”

Section: Discussionmentioning

confidence: 99%

“…8,11 Briefly, the ADVANCE III trial was a randomized, single-blind, parallel, multicenter trial that enrolled and analyzed 1902 patients undergoing their first implantation of a single-or dual-chamber ICD or a biventricular ICD (cardiac resynchronization therapy defibrillator [CRTD]) with a PP or SP indication from 94 centers in Europe, the Middle East, Russia, and Africa. Participants provided written informed consent, were randomly assigned to be programmed with a long-detection setting or with the standard-interval programming, and were followed up for 1 year.…”

Section: Methods Study Overview and Patient Selectionmentioning

confidence: 99%

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Efficacy of Long Detection Interval Implantable Cardioverter-Defibrillator Settings in Secondary Prevention Population

et al. 2014

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Background-Three trials demonstrated recently that a long detection window reduces implantable cardioverter-defibrillator (ICD) therapy in primary prevention patients. Avoid Delivering Therapies for Nonsustained Arrhythmias in ICD Patients III (ADVANCE III) was the only trial that enrolled both primary and secondary prevention patients. Methods and Results-Of the 1902 patients enrolled in the ADVANCE III trial, 477 received a defibrillator for secondary prevention; 248 patients were randomly assigned to a long detection setting (30 of 40 intervals) and 229 to the nominal setting (18 of 24 intervals) for ventricular arrhythmias with cycle length ≤320 ms. Eight-five percent of patients were men, with a mean age of 65±12 years, a previous history of ventricular fibrillation in 37% of the cases, and a mean ejection fraction of 38±13%. The ICD device mix was 37% single chamber, 47% dual chamber, and 16% triple chamber. Over a median period of 12 months, the long detection period was associated with a 25% reduction in the number of overall therapies (115.6 versus 86.8 per 100 patient-years; incidence rate ratio, 0.75; 95% confidence interval, 0.

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“…In the long detection arm there was an 81% reduction in shocks and significantly fewer "inappropriate" detections for non-sustained atrial tachyarrhythmia. We await ADVANCE III [39] a prospective randomised comparison of 30/40 with 18/24 detection, aiming to reduce shocks for non-sustained arrhythmia in the FVT zone (CL ≤ 320 ms). The subjects are primary and secondary prevention ICD recipients.…”

Section: Extending Detection Intervals For Reducing Inappropriate Thementioning

confidence: 99%

Recommendations for the Programming of Implantable Cardioverter-Defibrillators in New Zealand

Webber

Stiles

2012

Heart, Lung and Circulation

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Avoid Delivering Therapies for Nonsustained Fast Ventricular Tachyarrhythmia in Patients with Implantable Cardioverter/Defibrillator: The ADVANCE III Trial

Abstract: The ADVANCE III trial is the first randomized investigation evaluating the reduction of ICD Rx for fast VT due to a prolongation of NID in a general ICD patient cohort.

Cited by 22 publications

References 13 publications

Different impact of long-detection interval and anti-tachycardia pacing in reducing unnecessary shocks: data from the ADVANCE III trial

Different impact of long-detection interval and anti-tachycardia pacing in reducing unnecessary shocks: data from the ADVANCE III trial

Efficacy of Long Detection Interval Implantable Cardioverter-Defibrillator Settings in Secondary Prevention Population

Recommendations for the Programming of Implantable Cardioverter-Defibrillators in New Zealand

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