title: Relation between detection rate and inappropriate shocks in single versus dual chamber cardioverter-defibrillator--an analysis from the OPTION trial.
abstract: The programming of implantable cardioverter-defibrillators (ICDs) influences inappropriate shock rates. The aim of the study is to analyse rates of patients with appropriate and inappropriate shocks according to detection zones in the OPTION trial. All patients received dual chamber (DC) ICDs randomly assigned to be programmed either to single chamber (SC) or to DC settings including PARAD+ algorithm. In a post-hoc analysis, rates of patients with inappropriate and appropriate shocks were calculated for shocks triggered at heart rates ≥ 170 bpm (ventricular tachycardia zone) and at rates ≥ 200 bpm (ventricular fibrillation zone). In the SC group, higher rates of patients with total and inappropriate shocks were delivered at heart rates ≥ 170 bpm than at rates ≥ 200 bpm (total shocks: 21.1% vs. 16.6%; p = 0.002; inappropriate shocks: 7.6% vs. 4.5%, p = 0.016; appropriate shocks: 15.2% vs. 13.5%; p = n.s.). No such differences were observed in the DC group (total shocks: 14.3% vs. 12.6%; p = n.s.; inappropriate shocks: 3.9% vs. 3.6%; p = n.s.; appropriate shocks: 12.2% vs. 10.4%; p = n.s.). The higher frequency of patients with total shocks with SC settings than with DC settings that benefit from PARAD+ was driven by a higher percentage of patients with inappropriate shocks in the VT zone (170-200 bpm) in the SC population.
authors.affiliation: Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung für Elektrophysiologie, Faculty of Medicine, Technische Universität München, Munich, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Kolb
authors.affiliation: Sacre-Coeur Hospital, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Marcio
authors.initials: M
authors.lastname: Sturmer
authors.affiliation: University Hospital, Tours, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Babuty
authors.affiliation: Hospital of the Order of St. John of God, Regensburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Sick
authors.affiliation: Département de Cardiologie et Maladies Vasculaires, Hôpital Arnaud de Villeneuve, Montpellier, France.
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Davy
authors.affiliation: Cardiology Department, Ospedale Sacro Cuore, Negrar, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Molon
authors.affiliation: Department of Medicine, Cardiology, University Hospital, Bonn, Germany.
authors.forename: Jörg Otto
authors.initials: JO
authors.lastname: Schwab
authors.affiliation: Ospedale Civile, Desio, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mantovani
authors.affiliation: Piedmont Heart Institute, Atlanta, GA, United States of America.
authors.forename: Andrew
authors.initials: A
authors.lastname: Wickliffe
authors.affiliation: Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung für Elektrophysiologie, Faculty of Medicine, Technische Universität München, Munich, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Lennerz
authors.affiliation: Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung für Elektrophysiologie, Faculty of Medicine, Technische Universität München, Munich, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Semmler
authors.affiliation: Sorin CRM SAS, Clamart, France.
authors.forename: Pierre-Henri
authors.initials: PH
authors.lastname: Siot
authors.affiliation: Klinik für Kardiologie und Internistische Intensivmedizin, Städtisches Klinikum München-Bogenhausen, München, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Reif
mesh_terms: D000368:Aged; D000465:Algorithms; D016757:Death, Sudden, Cardiac; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012984:Software; D017180:Tachycardia, Ventricular / Q000628:therapy*; D016896:Treatment Outcome