Arrhythmias & electrophysiology
Reduction in inappropriate therapies through device programming in subcutaneous implantable defibrillator patients: data from clinical practice
Authors' conclusion
In recent years, S-ICD implanting centres have increasingly programmed high arrhythmia detection cut-off rates, at the time of implantation in the case of new S-ICD recipients, and during follow-up in the case of pre-existing implants. This has contributed significantly to reducing the incidence of inappropriate shocks in clinical practice.
Study context
- Population
- Consecutive subcutaneous implantable cardioverter defibrillator (S-ICD) recipients in 56 Italian centres
- Participants
- 1,468 recipients
- Exposure
- UNTOUCHED-like programming vs other S-ICD programming
- Outcome
- S-ICD programming at implantation and during follow-up; inappropriate and appropriate shocks
Methodological detailsmulticentre, 56 Italian centres, consecutive patients
- Multicentre
- 56 Italian centres
- Consecutive patients
Main finding
As reported in the abstract
Detection cut-off programming
- Median conditional zone cut-off at implantation (IQR 200-220)
- 200 bpm
- Median shock zone cut-off at implantation (IQR 210-250)
- 230 bpm
- Shock zone cut-off changed during follow-up
- 622 (42%)
- Median shock zone cut-off during follow-up (IQR 230-250), P < 0.001
- 250 bpm
- UNTOUCHED-like programming immediately after implantation
- 426 (29%)
- UNTOUCHED-like programming at last follow-up, P < 0.001
- 714 (49%)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Inappropriate shocks · follow-upUNTOUCHED-like programmingvs Other programmingIndependently associated | 0.50 (0.25–0.98) | P = 0.044 | |
| 0.20.5125Hazard ratio (log scale) |
Appropriate and ineffective shocks · follow-up
- No impact of UNTOUCHED-like programming
Original publication
Reduction in inappropriate therapies through device programming in subcutaneous implantable defibrillator patients: data from clinical practice. Europace. Published 18 March 2023. doi:10.
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