Navigation Links
Programming Implanted Defibrillators to React More Slowly Might Be Safer: Study
Date:5/8/2013

By Serena Gordon
HealthDay Reporter

TUESDAY, May 7 (HealthDay News) -- By slowing down the programmed response rate on implantable cardioverter defibrillators (ICDs), doctors can reduce the number of shocks these devices deliver without causing a significant increase in the risk of fainting or death, new research suggests.

"The aim of [our] study was to evaluate a different programming strategy to reduce unnecessary therapies delivered by the ICD," explained study author Dr. Maurizio Gasparini, chief of the pacing and electrophysiology unit at the Humanitas Clinical and Research Center in Rozzano, Italy.

"The study found that the strategy utilizing a long detection period to recognize arrhythmias [irregular heartbeats] is associated not only to an overall reduction of therapies, but also to less inappropriate shocks experienced by the patients as well as fewer hospitalizations in the 12 months following ICD implant," Gasparini said.

ICDs are small devices implanted in the upper chest. Electrodes from the device are attached to the heart. If an ICD senses a dangerous heartbeat or no heartbeat, it can help correct that through electrical pacing -- like a pacemaker -- or it can deliver a shock to the heart to restore a normal heartbeat, according to the U.S. National Heart, Lung, and Blood Institute.

Results of the study are published in the May 8 issue of the Journal of the American Medical Association. The study was funded by Medtronic Inc., which makes ICDs.

While ICDs can literally be lifesavers, they can also cause problems for some patients.

"Defibrillator shocks, whether for appropriate or inappropriate indications, are associated with adverse effects. These adverse effects include the acute discomfort of the shock, as well as late and longer-lasting psychological trauma including depression and post-traumatic stress disorder," wrote Dr. Merritt Raitt, author of an accompanying journal editorial. Raitt is with the Oregon Health and Science University and the Portland Veterans Administration Medical Center, in Oregon.

The current study included about 1,900 people who were receiving their first ICD implant. Their average age was 65, and 84 percent of the study volunteers were male.

The volunteers were randomly placed into one of two groups: standard programming or programming with a long detection interval.

"Every time the heart beats, an electrical activity is recorded by the device. An interval is the time between two consecutives beats. Basically it is the time between two heartbeats. So, a long detection interval simply means a longer period of time to permit recognition of arrhythmias," Gasparini explained.

During an average of 12 months of follow-up, 530 episodes of an arrhythmia were recorded. The long detection group had a 37 percent lower rate of delivered therapies (pacing or shocks) than the standard therapy group, according to the study.

There were no significant differences in mortality or in fainting (syncope) episodes between the groups.

"This study shows that we can decrease inappropriate and unnecessary therapies, and clearly you make people feel better because they're not getting inappropriate or unnecessary therapy, said Dr. Ranjit Suri, director of the electrophysiology service and Cardiac Arrhythmia Center at Lenox Hill Hospital in New York City.

However, Suri said it's not yet clear what the ideal interval time is. The current study doesn't show a benefit in terms of reduced risk of death. Another study, published last December in the New England Journal of Medicine, did find a mortality benefit. But, the interval was longer in that study.

Still, Suri said, doctors could start programming ICDs with longer intervals, and making such a change to the device isn't difficult or time-consuming.

In his editorial, Raitt wrote: "Regardless of whether these programming interventions lead to reduced mortality, the unequivocal reduction in ICD shocks and the reduction in hospitalization without an increase in adverse events such as syncope suggests that this programming approach should be considered for adoption in the care of patients with ICDs and clinical characteristics similar to those enrolled in these studies."

Study author Gasparini noted that the research provides physicians with an easy programming guideline that's "applicable to the great majority of patients who may benefit from the reduction of unnecessary painful shocks and hospitalizations."

More information

Learn more about implantable cardioverter defibrillator from the U.S. National Heart, Lung, and Blood Institute.

SOURCES: Maurizio Gasparini, M.D., chief, pacing and electrophysiology unit, Humanitas Clinical and Research Center, Rozzano, Italy; Ranjit Suri, M.D., director, electrophysiology service and the Cardiac Arrhythmia Center, Lenox Hill Hospital, New York City; May 8, 2013, Journal of the American Medical Association


'/>"/>
Copyright©2012 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Reprogramming cells to fight diabetes
2. Robot allows remote presence in programming brain and spine stimulators
3. A relationship between cancer genes and the reprogramming gene SOX2 discovered
4. Programming Change in Defibrillator Implants May Lower Death Risk: Study
5. Steffi Nossen School of Dance Gears Up for Summer with Exciting Programming for All Ages
6. Implanted Device May Predict Epilepsy Seizures, Study Suggests
7. Researchers Test Implanted Brain Stimulator for Alzheimers
8. Mayo Clinic study finds electric car does not interfere with implanted cardiac devices
9. Weight loss linked to higher risk with implanted defibrillators
10. Implanted Defibrillator Patients Prefer Device Off if Very Ill: Survey
11. Implanted Heart Devices Have Real-World Benefits: Study
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Programming Implanted Defibrillators to React More Slowly Might Be Safer: Study
(Date:10/13/2017)... ... October 13, 2017 , ... The Visiting Nurse Association (VNA) of Somerset ... of specialty vendors and unique items from across the nation, this holiday-themed event will ... services offered by the VNA. The boutique will be open Saturday, November 4 ...
(Date:10/13/2017)... ... October 13, 2017 , ... Coveros, a leader ... been awarded a contract by the Center for Medicare and Medicaid Services (CMS). ... the enterprise use of Agile methodologies in a consistent and high value manner ...
(Date:10/12/2017)... ... October 12, 2017 , ... Planet Fitness, one of the ... today its plans to open a flagship location in Covington, LA at 401 N. ... To Go store next to Office Depot in the Holiday Square shopping center. Its ...
(Date:10/12/2017)... , ... October 12, 2017 , ... ... delivery system that we intend to develop to enable prevention of a major ... to severe hearing loss, especially in pediatric patients. For cisplatin, hearing loss is ...
(Date:10/12/2017)... ... October 12, 2017 , ... ... of Michigan’s 2017 Best and Brightest in Wellness® by Best and Brightest. OnSite ... program on Friday, Oct. 20 from 7:30 a.m. to 2 p.m. at the ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... -- Eli Lilly and Company (NYSE: LLY ) ... of 2017 on Tuesday, October 24, 2017. Lilly will ... the investment community and media to further detail the ... begin at 9 a.m. Eastern time. Investors, media and ... the conference call through a link that will be ...
(Date:9/28/2017)... , Sept. 28, 2017 Hill-Rom Holdings, Inc. ... earnings conference call and webcast on Friday, November 3, ... (EDT) and ending at approximately 8:30 a.m. (CDT) / ... the company,s 2017 financial performance and guidance for 2018, ... initiatives to enhance operational performance, and long-range financial outlook ...
(Date:9/25/2017)... 25, 2017   Montrium , an industry ... today—from the IQPC Trial Master Files & Inspection ... that EastHORN Clinical Services has selected eTMF ... TMF management. EastHORN, a leading European contract research ... increase transparency to enable greater collaboration with sponsors, ...
Breaking Medicine Technology: