title: Shock avoidance and the newer tachycardia therapy algorithms.
abstract: Sudden cardiac death is a leading cause of death in the United States and Europe. Implantable cardioverter defibrillators (ICDs) are a cornerstone of therapy for patients at risk of first occurrence of ventricular arrhythmia, or secondary prevention in those who have previously suffered cardiac arrest or life-threatening arrhythmias. Despite their efficacy, ICD shocks are associated with significant physical and psychological adverse effects. As technology has progressed, newer device programing methods have allowed for arrhythmia suppression and termination without the need for high-energy defibrillation, thus improving patient satisfaction, health, and outcomes.
authors.affiliation: Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: Kushwin
authors.initials: K
authors.lastname: Rajamani
authors.affiliation: Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Goldberg
authors.affiliation: Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Electronic address: wilkofb@ccf.org.
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Wilkoff
mesh_terms: D000465:Algorithms; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation / Q000379:methods; D003131:Combined Modality Therapy; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004554:Electric Countershock / Q000009:adverse effects; D004556:Electric Injuries / Q000517:prevention & control; D006801:Humans; D017060:Patient Satisfaction; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011788:Quality of Life; D013610:Tachycardia / Q000628:therapy*; D016896:Treatment Outcome; D019564:Unnecessary Procedures
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Antitachycardia pacing (ATP); Avoidable shocks; ICD programming; Inappropriate shocks