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

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 progr
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Programming Implanted Defibrillators to React More Slowly Might Be Safer: Study
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