Does programming the automatic defibrillator decrease asymptomatic shocks?

Minimizing inappropriate or "unnecessary" implantable cardioverter-defibrillator shocks: appropriate programming.

Life-saving shocks are the raisons d’être of implantable cardioverter-defibrillators (ICDs). Paradoxically, shocks also cause much of the morbidity associated with ICDs. Consistently, shocks reduce quality of life,1,2 and rarely, they may cause proarrhythmia.3,4 Additionally, shocks have been reported to be associated with excess mortality.5 Experts disagree about whether shocks are responsible...

Improper Implantable Cardioverter Defibrillator Shocks

The second ECG recorded supraventricular tachycardia at the time his hemodynamic status deteriorated and decision was made to perform electrical cardioversion with 120 Joules of biphasic synchronized direct current with follow up ECG that showed atrial paced rhythm (Figure 1B). His condition improved and started on amiodarone 200 mg, anticoagulation, and subsequent follow up for ICD reprogrammi...

Inappropriate Implantable Cardioverter-Defibrillator Shocks

Results A total of 1,544 ICD patients (79% male, age 61 13 years) were included in the analysis. During the follow-up period of 41 18 months, 13% experienced 1 inappropriate shocks. The cumulative incidence steadily increased to 18% at 5-year follow-up. Independent predictors of the occurrence of inappropriate shocks included a history of atrial fibrillation (hazard ratio [HR]: 2.0, p 0.01) and...

Prognostic Significance of Implantable Cardioverter-Defibrillator Shocks

The Automatic External Cardioverter-Defibrillator

In-hospital cardiac arrest remains a major problem but new technologies allowing fully automatic external defibrillation are available. These technologies allow the concept of "external therapeutic monitoring" of lethal arrhythmias. Since early defibrillation improves outcome by decreasing morbidity and mortality, the use of this device should improve the outcome of in-hospital cardiac arrest v...