Valentina Kutyifa1, James P Daubert2, Claudio Schuger2, Ilan Goldenberg2, Helmut Klein2, Mehmet K Aktas2, Scott McNitt2, Martin Stockburger2, Bela Merkely2, Wojciech Zareba2, Arthur J Moss2. 1. From the University of Rochester Medical Center, Heart Research Follow-Up Program, Rochester, NY (V.K., I.G., H.K., M.K.A., S.M., W.Z., A.J.M.); Duke University Medical Center, Division of Cardiology, Durham, NC (J.P.D.); Henry Ford Hospital, Detroit, MI (C.S.); Experimental and Clinical Research Center, a Joint Cooperation between the Charité Medical Faculty and the Max-Delbrueck Center for Molecular Medicine, Berlin, Germany (M.S.); and Semmelweis University, Heart and Vascular Center, Budapest, Hungary (B.M.). Valentina.Kutyifa@heart.rochester.edu. 2. From the University of Rochester Medical Center, Heart Research Follow-Up Program, Rochester, NY (V.K., I.G., H.K., M.K.A., S.M., W.Z., A.J.M.); Duke University Medical Center, Division of Cardiology, Durham, NC (J.P.D.); Henry Ford Hospital, Detroit, MI (C.S.); Experimental and Clinical Research Center, a Joint Cooperation between the Charité Medical Faculty and the Max-Delbrueck Center for Molecular Medicine, Berlin, Germany (M.S.); and Semmelweis University, Heart and Vascular Center, Budapest, Hungary (B.M.).
Abstract
BACKGROUND: The Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate therapy (MADIT-RIT) trial showed a significant reduction in inappropriate implantable cardioverter defibrillator (ICD) therapy in patients programmed to high-rate cut-off (Arm B) or delayed ventricular tachycardia therapy (Arm C), compared with conventional programming (Arm A). There is limited data on the effect of cardiac resynchronization therapy with a cardioverter defibrillator (CRT-D) on the effect of ICD programming. We aimed to elucidate the effect of CRT-D on ICD programming to reduce inappropriate ICD therapy in patients implanted with CRT-D or an ICD, enrolled in MADIT-RIT. METHODS AND RESULTS: The primary end point of this study was the first inappropriate ICD therapy. Secondary end points were inappropriate anti-tachycardia pacing and inappropriate ICD shock. The study enrolled 742 (49%) patients with an ICD and 757 (51%) patients with a CRT-D. Patients implanted with a CRT-D had 62% lower risk of inappropriate ICD therapy than those with an ICD only (hazard ratio [HR] =0.38, 95% confidence interval: 0.25-0.57; P<0.001). High-rate cut-off or delayed ventricular tachycardia therapy programming significantly reduced the risk of inappropriate ICD therapy compared with conventional ICD programming in ICD (HR=0.14 [B versus A]; HR=0.21 [C versus A]) and CRT-D patients (HR=0.15 [B versus A]; HR=0.23 [C versus A]; P<0.001 for all). There was a significant reduction in inappropriate anti-tachycardia pacings in both group and a significant reduction in inappropriate ICD shock in CRT-D patients. CONCLUSIONS: Patients implanted with a CRT-D have lower risk of inappropriate ICD therapy than those with an ICD. Innovative ICD programming significantly reduces the risk of inappropriate ICD therapy in both ICD and CRT-D patients. CLINICAL TRIAL REGISTRATION: http://clinicaltrials.gov; Unique identifier: NCT00947310.
RCT Entities:
BACKGROUND: The Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate therapy (MADIT-RIT) trial showed a significant reduction in inappropriate implantable cardioverter defibrillator (ICD) therapy in patients programmed to high-rate cut-off (Arm B) or delayed ventricular tachycardia therapy (Arm C), compared with conventional programming (Arm A). There is limited data on the effect of cardiac resynchronization therapy with a cardioverter defibrillator (CRT-D) on the effect of ICD programming. We aimed to elucidate the effect of CRT-D on ICD programming to reduce inappropriate ICD therapy in patients implanted with CRT-D or an ICD, enrolled in MADIT-RIT. METHODS AND RESULTS: The primary end point of this study was the first inappropriate ICD therapy. Secondary end points were inappropriate anti-tachycardia pacing and inappropriate ICD shock. The study enrolled 742 (49%) patients with an ICD and 757 (51%) patients with a CRT-D. Patients implanted with a CRT-D had 62% lower risk of inappropriate ICD therapy than those with an ICD only (hazard ratio [HR] =0.38, 95% confidence interval: 0.25-0.57; P<0.001). High-rate cut-off or delayed ventricular tachycardia therapy programming significantly reduced the risk of inappropriate ICD therapy compared with conventional ICD programming in ICD (HR=0.14 [B versus A]; HR=0.21 [C versus A]) and CRT-D patients (HR=0.15 [B versus A]; HR=0.23 [C versus A]; P<0.001 for all). There was a significant reduction in inappropriate anti-tachycardia pacings in both group and a significant reduction in inappropriate ICD shock in CRT-D patients. CONCLUSIONS:Patients implanted with a CRT-D have lower risk of inappropriate ICD therapy than those with an ICD. Innovative ICD programming significantly reduces the risk of inappropriate ICD therapy in both ICD and CRT-D patients. CLINICAL TRIAL REGISTRATION: http://clinicaltrials.gov; Unique identifier: NCT00947310.
Authors: Johann Christoph Geller; Armin Wöhrle; Mathias Busch; Albrecht Elsässer; Thomas Kleemann; Frank Birkenhauer; Peter Bramlage; Christian Veltmann Journal: J Interv Card Electrophysiol Date: 2020-07-14 Impact factor: 1.900
Authors: Vincenzo Russo; Anna Rago; Vincenzo Ruggiero; Francesca Cavaliere; Valter Bianchi; Ernesto Ammendola; Andrea Antonio Papa; Vincenzo Tavoletta; Stefano De Vivo; Paolo Golino; Antonio D'Onofrio; Gerardo Nigro Journal: Front Cardiovasc Med Date: 2022-05-16
Authors: Yitschak Biton; Usama A Daimee; Jayson R Baman; Valentina Kutyifa; Scott McNitt; Bronislava Polonsky; Wojciech Zareba; Ilan Goldenberg Journal: J Am Heart Assoc Date: 2019-03-19 Impact factor: 5.501