Arrhythmias & electrophysiologyResearch article
Improved implantable cardioverter-defibrillator shock efficacy using programmable pulse width
- Intrapatient comparison of shock waveform types using remote monitoring data
- within-patient comparison
Authors' conclusion
Reprogramming shock waveforms from 65% fixed tilt to fixed pulse width significantly improved intrapatient shock success.
Study context
- Population
- US patients with single-coil implantable cardioverter-defibrillator (ICD) or CRT-D devices (Ellipse, Assura, Unify, and Fortify, Abbott) who received defibrillation or cardioversion shock therapy when programmed to both 65% fixed tilt and fixed pulse width modes for distinct periodspatients experiencing at least 1 shock-delivered episode with each shock type, 157 [57%] with ICDs, 120 [43%] with CRT-Ds · ICDs 157 · CRT-Ds 120
- Participants
- 277 patients
- Comparison
- fixed pulse width vs fixed tilt waveforms
Main finding
As reported in the abstract
First-shock success rate
P < 0.001
Further findings
Delivered shock energy, in patients with greater-or-equal first-shock success · comparable energies
P = 0.53
| Outcome | fixed pulse width | fixed tilt | P value |
|---|---|---|---|
| 100% first-shock success · more patients with fixed pulse width | 69.3% of episodes | 46.2% of patients | P < 0.001 |
Greater-or-equal first-shock success with fixed pulse width
- patients with greater-or-equal first-shock success with fixed pulse width
- 79.4% of patients (220 of 277)
Original publication
Improved implantable cardioverter-defibrillator shock efficacy using programmable pulse width. Heart Rhythm. Published 27 April 2026. doi:10.1016/j.hrthm.2026.04.035
Summarised from the published abstract; every number is checked against it