title: The effect of ICD programming on inappropriate and appropriate ICD Therapies in ischemic and nonischemic cardiomyopathy: the MADIT-RIT trial.
abstract: BACKGROUND
  The MADIT-RIT trial demonstrated reduction of inappropriate and appropriate ICD therapies and mortality by high-rate cut-off and 60-second-delayed VT therapy ICD programming in patients with a primary prophylactic ICD indication. The aim of this analysis was to study effects of MADIT-RIT ICD programming in patients with ischemic and nonischemic cardiomyopathy.
  
  
  RESULTS
  First and total occurrences of both inappropriate and appropriate ICD therapies were analyzed by multivariate Cox models in 791 (53%) patients with ischemic and 707 (47%) patients with nonischemic cardiomyopathy. Patients with ischemic and nonischemic cardiomyopathy had similar incidence of first inappropriate (9% and 11%, P = 0.21) and first appropriate ICD therapy (11.6% and 14.1%, P = 0.15). Patients with ischemic cardiomyopathy had higher mortality rate (6.1% vs. 3.3%, P = 0.01). MADIT-RIT high-rate cut-off (arm B) and delayed VT therapy ICD programming (arm C) compared with conventional (arm A) ICD programming were associated with a significant risk reduction of first inappropriate and appropriate ICD therapy in patients with ischemic and nonischemic cardiomyopathy (HR range 0.11-0.34, P < 0.001 for all comparisons). Occurrence of total inappropriate and appropriate ICD therapies was significantly reduced by high-rate cut-off ICD programming and delayed VT therapy ICD programming in both ischemic and nonischemic cardiomyopathy patients.
  
  
  CONCLUSIONS
  High-rate cut-off and delayed VT therapy ICD programming are associated with significant reduction in first and total inappropriate and appropriate ICD therapy in patients with ischemic and nonischemic cardiomyopathy.
authors.affiliation: Cardiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Kamil
authors.initials: K
authors.lastname: Sedláček
authors.affiliation: The Heart Research Follow-up Program, University of Rochester Medical Center, Rochester, New York, USA.|Department of Cardiology, Gentofte Hospital, Hellerup, Denmark.
authors.forename: Anne-Christine
authors.initials: AC
authors.lastname: Ruwald
authors.affiliation: The Heart Research Follow-up Program, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Valentina
authors.initials: V
authors.lastname: Kutyifa
authors.affiliation: The Heart Research Follow-up Program, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: McNitt
authors.affiliation: Faculty of Medicine, University of Aalborg, Aalborg, Denmark.
authors.forename: Poul Erik Bloch
authors.initials: PEB
authors.lastname: Thomsen
authors.affiliation: The Heart Research Follow-up Program, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Helmut
authors.initials: H
authors.lastname: Klein
authors.affiliation: Charite-Universitätsmedizin Berlin, Experimental and Clinical Research Centre, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Stockburger
authors.affiliation: Cardiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Dan
authors.initials: D
authors.lastname: Wichterle
authors.affiliation: Heart Centre, Semmelweis University, Budapest, Hungary.
authors.forename: Bela
authors.initials: B
authors.lastname: Merkely
authors.affiliation: Hospital Infanta Christina, Badajoz, Spain.
authors.forename: Joaquin Fernandez
authors.initials: JF
authors.lastname: DE LA Concha
authors.affiliation: Kaplan Medical Centre Heart Institute, Bitaniz, Rehovot, Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Swissa
authors.affiliation: The Heart Research Follow-up Program, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zareba
authors.affiliation: The Heart Research Follow-up Program, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Moss
authors.affiliation: Cardiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Kautzner
authors.affiliation: The Heart Research Follow-up Program, University of Rochester Medical Center, Rochester, New York, USA.|Department of Cardiology, Gentofte Hospital, Hellerup, Denmark.
authors.forename: Martin H
authors.initials: MH
authors.lastname: Ruwald
mesh_terms: D000368:Aged; D009202:Cardiomyopathies / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D016009:Chi-Square Distribution; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D022062:Electrophysiologic Techniques, Cardiac; D004867:Equipment Design; D004868:Equipment Failure; D005060:Europe; D005260:Female; D006801:Humans; D007557:Israel; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D012815:Signal Processing, Computer-Assisted; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
keywords: MADIT-RIT trial; appropriate ICD therapy; implantable cardioverter defibrillators; inappropriate ICD therapy; ischemic cardiomyopathy; nonischemic cardiomyopathy