Mauro Biffi1. 1. Institute of Cardiology, Policlinico S. Orsola-Malpighi, University of Bologna, Italy. Electronic address: mauro.biffi@aosp.bo.it.
Abstract
BACKGROUND: Appropriate ICD programming is the key to prevent inappropriate shock delivery, that is closely associated to a negative patients' outcome. METHODS: Review of the literature on ICD therapy to generate ICD programmings that can be applied to the broad population of ICD and CRT-D carriers. RESULTS: Arrhythmia detection should occur with a detection time ranging 9″-12″ in the VF zone, and 15″-60″ in the VT zone. Discriminator should be applied at least up to 200 bpm. ATP therapy is applied to all VTs up to 250 bpm, with a success rate of 70%. Inappropriate shocks should occur in <3.6% of patients. CONCLUSION: Tailored ICD programming can be achieved following evidence from large ICD trials. Pre-defined settings that are saved on the programmer and that can be uploaded at device implantation help to ensure optimal programming and to avoid random errors.
BACKGROUND: Appropriate ICD programming is the key to prevent inappropriate shock delivery, that is closely associated to a negative patients' outcome. METHODS: Review of the literature on ICD therapy to generate ICD programmings that can be applied to the broad population of ICD and CRT-D carriers. RESULTS:Arrhythmia detection should occur with a detection time ranging 9″-12″ in the VF zone, and 15″-60″ in the VT zone. Discriminator should be applied at least up to 200 bpm. ATP therapy is applied to all VTs up to 250 bpm, with a success rate of 70%. Inappropriate shocks should occur in <3.6% of patients. CONCLUSION: Tailored ICD programming can be achieved following evidence from large ICD trials. Pre-defined settings that are saved on the programmer and that can be uploaded at device implantation help to ensure optimal programming and to avoid random errors.
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