Programming of implantable cardioverter defibrillators for primary prevention: outcomes at centers with high vs. low concordance with guidelines

Teerawongsakul, Padoemwut; Ananwattanasuk, Teetouch; Chokesuwattanaskul, Ronpichai; Shah, Muazzum M.; Lathkar‐Pradhan, Sangeeta; Barham, Waseem; Oral, Hakan; Thakur, Ranjan K.; Jongnarangsin, Krit; Tanawuttiwat, Tanyanan

doi:10.1007/s10840-022-01431-6

J Interv Card Electrophysiol

2022

DOI: 10.1007/s10840-022-01431-6

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Programming of implantable cardioverter defibrillators for primary prevention: outcomes at centers with high vs. low concordance with guidelines

Padoemwut Teerawongsakul

Teetouch Ananwattanasuk

Ronpichai Chokesuwattanaskul

et al.

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Cited by 3 publications

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“…In this issue of the Journal of Interventional Cardiac Electrophysiology, Teerawongsakul and colleagues report an observational analysis of two high-volume academic electrophysiology centers in the USA, using data from their device clinics between 2014 and 2016 [7]. The authors found that in one center, 47% of initial programming in primary prevention patients was appropriate and guideline concordant, while the other center only had 1% of patients with guideline concordant ICD programming.…”

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confidence: 99%

Primary prevention programming for defibrillators: need for a device clinic-based intervention

Atreya

Mounsey

2023

J Interv Card Electrophysiol

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mentioning

confidence: 99%

Primary prevention programming for defibrillators: need for a device clinic-based intervention

Atreya

Mounsey

2023

J Interv Card Electrophysiol

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Incidence and risk factors for first and recurrent ICD shock therapy in patients with an implantable cardioverter defibrillator

Frodi,

Diederichsen,

Xing

et al. 2024

J Interv Card Electrophysiol

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Background Advances in medical treatment and outcomes in implantable cardioverter-defibrillator (ICD) recipients incentivize a need for improved candidate selection and identification of risk factors for ICD therapy. We examined contemporary rates of and risk factors for ICD therapy. Methods Patients with ICD for primary (PP) or secondary prevention (SP), implanted between January 2010 and December 2020, were followed for appropriate and inappropriate incident and recurrent shock. Results Overall, 2998 patients (mean age 61.8 ± 12.7 years, 20% female, 73% ICD carriers, and 47.1% SP) were analyzed with a median follow-up of 4.3 (interquartile range (IQR) 2.1–7.4) years. A total of 426/2998 (14.2%) patients had shock; 364/2998 (12.1%) had appropriate and 82/2998 (2.7%) inappropriate shock, with annualized event rates of 2.34 (2.11–2.59) and 0.49 (0.39–0.61) per 100 person-years, respectively. Of those with shock, 133/364 (36.5%) experienced recurrent appropriate shock and 8/364 (2.2%) received recurrent inappropriate shock, with event rates of 10.57 (8.85–12.53) and 0.46 (0.20–0.92), respectively. In multivariable analyses, female sex was associated with a reduced risk of incident appropriate shock (hazard ratio 0.69 [95% confidence interval 0.52; 0.91]). Of other variables, only revascularization status was associated with recurrent appropriate shock in PP, and CRT-D with recurrent appropriate shock in the overall cohort. Conclusion One in eight ICD recipients received appropriate shock 2–7 years after guideline-directed implantation. More than one-third of patients with a first shock experienced recurrent shock. Few clinical variables showed potential in predicting shocks, illustrating a need for more advanced tools to select candidates for implantation. Graphical Abstract

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Clinical Decision Making and Technical Approaches in Implantable Cardioverter-Defibrillator Procedures: A Step by Step Critical Appraisal of Literature

Roseboom,

Smit,

Groenveld

et al. 2024

Rev. Cardiovasc. Med.

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The selection of an appropriate implantable cardioverter-defibrillator (ICD) type and implantation strategy involves a myriad of considerations. While transvenous ICDs are standard, the rise of non-transvenous options like subcutaneous ICDs and extravascular ICDs is notable for their lower complication rates. Historical preferences for dual chamber ICDs have shifted to single-chamber ICDs. Single-coil ICDs are preferred for easier extraction, and the use of the DF-4 connector is generally recommended. Cephalic cutdown is the preferred venous access technique, while axillary vein puncture is a viable alternative. The right ventricular apex remains the preferred lead position until further evidence on conduction system pacing emerges. Left-sided, subcutaneous ICD implantation is considered reliable, contingent on specific cases. A meticulous perioperative plan, including antibiotic prophylaxis and an antithrombotic regimen, is crucial for successful implantation.

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Programming of implantable cardioverter defibrillators for primary prevention: outcomes at centers with high vs. low concordance with guidelines

Cited by 3 publications

References 21 publications

Primary prevention programming for defibrillators: need for a device clinic-based intervention

Primary prevention programming for defibrillators: need for a device clinic-based intervention

Incidence and risk factors for first and recurrent ICD shock therapy in patients with an implantable cardioverter defibrillator

Clinical Decision Making and Technical Approaches in Implantable Cardioverter-Defibrillator Procedures: A Step by Step Critical Appraisal of Literature

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