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Novel ICD Programming and Inappropriate ICD Therapy in CRT-D Versus ICD Patients: A MADIT-RIT Sub-Study.

Publication ,  Journal Article
Kutyifa, V; Daubert, JP; Schuger, C; Goldenberg, I; Klein, H; Aktas, MK; McNitt, S; Stockburger, M; Merkely, B; Zareba, W; Moss, AJ
Published in: Circ Arrhythm Electrophysiol
January 2016

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.

Duke Scholars

Published In

Circ Arrhythm Electrophysiol

DOI

EISSN

1941-3084

Publication Date

January 2016

Volume

9

Issue

1

Start / End Page

e001965

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Tachycardia, Ventricular
  • Tachycardia, Supraventricular
  • Survival Rate
  • Risk Factors
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
 

Citation

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Kutyifa, V., Daubert, J. P., Schuger, C., Goldenberg, I., Klein, H., Aktas, M. K., … Moss, A. J. (2016). Novel ICD Programming and Inappropriate ICD Therapy in CRT-D Versus ICD Patients: A MADIT-RIT Sub-Study. Circ Arrhythm Electrophysiol, 9(1), e001965. https://doi.org/10.1161/CIRCEP.114.001965
Kutyifa, Valentina, James P. Daubert, Claudio Schuger, Ilan Goldenberg, Helmut Klein, Mehmet K. Aktas, Scott McNitt, et al. “Novel ICD Programming and Inappropriate ICD Therapy in CRT-D Versus ICD Patients: A MADIT-RIT Sub-Study.Circ Arrhythm Electrophysiol 9, no. 1 (January 2016): e001965. https://doi.org/10.1161/CIRCEP.114.001965.
Kutyifa V, Daubert JP, Schuger C, Goldenberg I, Klein H, Aktas MK, et al. Novel ICD Programming and Inappropriate ICD Therapy in CRT-D Versus ICD Patients: A MADIT-RIT Sub-Study. Circ Arrhythm Electrophysiol. 2016 Jan;9(1):e001965.
Kutyifa, Valentina, et al. “Novel ICD Programming and Inappropriate ICD Therapy in CRT-D Versus ICD Patients: A MADIT-RIT Sub-Study.Circ Arrhythm Electrophysiol, vol. 9, no. 1, Jan. 2016, p. e001965. Pubmed, doi:10.1161/CIRCEP.114.001965.
Kutyifa V, Daubert JP, Schuger C, Goldenberg I, Klein H, Aktas MK, McNitt S, Stockburger M, Merkely B, Zareba W, Moss AJ. Novel ICD Programming and Inappropriate ICD Therapy in CRT-D Versus ICD Patients: A MADIT-RIT Sub-Study. Circ Arrhythm Electrophysiol. 2016 Jan;9(1):e001965.

Published In

Circ Arrhythm Electrophysiol

DOI

EISSN

1941-3084

Publication Date

January 2016

Volume

9

Issue

1

Start / End Page

e001965

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Tachycardia, Ventricular
  • Tachycardia, Supraventricular
  • Survival Rate
  • Risk Factors
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate