| Optimizing ICD programming for shock reduction. | |
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MedLine Citation:
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PMID: 20825486 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Abstract With the increasing numbers of patients with implantable cardioverter/defibrillators for primary prevention (PP), the topic of inappropriate therapy becomes more and more important. If a shock intervention, e.g. for rapidly conducted atrial fibrillation or fast VT (FVT), represents the first reminder of the implantable cardioverter/defibrillator (ICD), the adherence to the therapy will decrease. Moreover, anxiety to receive the next inappropriate ICD Rx is able to initiate a bad quality of life or depression. Starting with the PainFREE Rx II Trial results, the programming of antitachycardia pacing was able to terminate even fast ventricular arrhythmia, i.e. ≥188 bpm, in three of four episodes. Thereafter, several studies evaluated whether a prolongation in ventricular tachyarrhythmia (VT) detection is able to reduce unnecessary ICD Rx owing to nonsustained VT. The PREPARE trial evaluated this concept in a cohort of PP patients. This nonrandomized study compared a historical control group to patients with a prolonged detection interval. The results underline the idea that an extension in detection time leads to a significant decrease in ICD Rx for supra- as well as VT. The RELEVANT study investigated in a randomized fashion the outcome of an increase in detection time in nonischemic patients under CRT including an ICD. The findings clearly demonstrated a reduction in ICD Rx as well as hospital admissions, significantly. Currently, the ADVANCE III trial investigates a 30/40 interval detection compared to 18/24 for FVT in prospective randomized fashion in patients for primary or secondary prevention including all ICD devices. |
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Authors:
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Joerg O Schwab |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2010-9-03 |
Journal Detail:
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Title: Fundamental & clinical pharmacology Volume: - ISSN: 1472-8206 ISO Abbreviation: - Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-9-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8710411 Medline TA: Fundam Clin Pharmacol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Medicine - Cardiology, University of Bonn, Sigmund-Freud, Str. 25, 53105 Bonn, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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