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New Software for Defibrillators Lowers Risk of Unnecessary Shocks
Date:9/28/2010

from the market in 2007.)

"Some doctors have been pulling these leads out prophylactically because they're worried about fractures, but what they often don't consider is that there are significant risks associated with lead replacement surgery," noted Swerdlow, who added that he hoped these findings encourage doctors to consider other options before replacing ICD leads.

Earlier this year, researchers reported that a new type of ICD that can be implanted just under the patient's skin and eliminate the need for electrical leads altogether may be just as effective as conventional models, but electrophysiologists say larger and longer-term studies are needed to prove their safety and efficacy.

For the software study, Swerdlow and his co-authors compared the experience of 426 patients prior to surgery to replace fractured leads. Half of the patients received standard daily monitoring and half were monitored with the addition of the downloadable LIA software. Among the patients who had standard monitoring, 70 percent received one or more inappropriate shocks, compared with only 38 percent of those who were monitored with the help of LIA software. Five or more inappropriate shocks were delivered to 50 percent of the patients who received standard monitoring, but only 25 percent of patients with LIA.

The researchers also found that 72 percent of patients with LIA had no inappropriate shock, or had at least three days warning prior to an inappropriate shock, compared with only 50 percent of those who received standard monitoring.

Many electrophysiologists began using the software soon after the FDA approved it in August 2008, said Dr. Andrea M. Russo, director of Cardiac Electrophysiology and Arrhythmia Services at Cooper University Hospital in Camden, N.J.

"Inappropriate shocks are much more damaging, psychologically, [than necessary electrical jolts] so we need to aim to eliminate every shock that's unnecessary," said Russo, who is a
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