Arrhythmias & electrophysiology
Inappropriate therapies in modern implantable cardioverter-defibrillators: A propensity score–matched comparison between single- and dual-chamber discriminators in single-chamber devices THe sINGle lead Study (THINGS Study)
Authors' conclusion
High-rate VF cutoff and prolonged detection time programming resulted in a low IT rate in single-lead ICD patients with modern SVT discriminators. A trend favoring the DC system was observed in the VT zone.
Study context
- Population
- Patients with single-lead implantable cardioverter-defibrillators (ICDs) (median age 66 years; 83% male)median follow-up 2.2 years
- Participants
- 526 patients
- Exposure
- Dual-chamber vs single-chamber SVT discrimination in single-lead ICDs
- Dual chamber (DC)n = 183
- Single chamber (SC)n = 343reference
- Outcome
- First occurrence of inappropriate therapy, adjudicated by an independent board
Methodological detailspropensity-score matched comparison, 2-zone programming: Ventricular tachycardia (VT) zone from 170 beats/min, ≥15 s (≥36 beats) detection with SVT discriminators; Ventricular fibrillation (VF) zone from 214 beats/min, ≥7 s (≥24 beats) detection
- Propensity-score matched comparison
- 2-zone programming: VT zone from 170 beats/min, ≥15 s (≥36 beats) detection with SVT discriminators; VF zone from 214 beats/min, ≥7 s (≥24 beats) detection
Main finding
As reported in the abstract
Incidence of inappropriate therapy (all patients)
IT incidence at 1 year
4.2%
95% CI 2.7%–6.4%
IT incidence at 2 years
7.1%
95% CI 5.0%–9.9%
Observational data: associations, not effects.
Further findings
Predictors of IT
| Adjusted HR (95% CI) | P value | ||
|---|---|---|---|
| Age (younger age associated with increased IT risk) | 0.97 (0.95–0.99) | P = 0.013 | |
| History of AF | 2.67 (1.30–5.46) | P = 0.007 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
IT in VT zone, DC vs SC · 1 year · trend toward reduced IT with DC · propensity score-matched comparison
P = 0.105
Original publication
Inappropriate therapies in modern implantable cardioverter-defibrillators: A propensity score–matched comparison between single- and dual-chamber discriminators in single-chamber devices THe sINGle lead Study (THINGS Study). Heart Rhythm. Published 5 October 2024. doi:10.
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