Real world evaluation of dual-zone ICD and CRT-D programming compared to single-zone programming: The ALTITUDE REDUCES study

F. Roosevelt Gilliam, David L. Hayes, John Boehmer, John Day, Paul A. Heidenreich, Milan Seth, Paul W. Jones, Kenneth M. Stein, Leslie A. Saxon

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Tachycardia Detection, ICD, CRT-D Devices, Appropriate and Inappropriate Shock. Introduction: We evaluated the frequency of appropriate and inappropriate shocks and survival in patients using dual-zone programming versus single-zone programming. Methods and Results: For the ALTITUDE REDUCES study, patients were followed for 1.6 ± 1.1 years. The 12-month incidence of any shock was lower for dual-versus single-zone programmed detection at rates 200 bpm (P < 0.001). Appropriate shock rates at 1 year were also lower with dual-zone programming in these rate intervals (single zone 9.1%, 5.4%, P < 0.001, dual zone 6.7%, 4.7%, P < 0.02). There were no detectable differences between single- and dual-zone shock incidence at detection rates ≥ 200 bpm (P = 0.14). Inappropriate shock incidence was less with dual- versus single-zone detection at all detect rates <200 bpm, but not at rates ≥200 bpm (P < 0.001, P = 0.37). The lowest risk of appropriate and inappropriate shock was associated with dual-zone programming and detection rates ≥200 bpm (2.1%). Dual-zone detection was associated with more nonsustained and diverted therapy episodes but these patients did not have an increased risk of death compared to patients with single-zone programming. Patients programmed to low detection rate, single-zone detection and shock-only therapy also had the highest preshock mortality risk (P = 0.05). Conclusions: Shock incidence is lowest with either single- or dual-zone detection ≥200 bpm. For detection rates <200 bpm, dual-zone programming is associated with a reduction in the incidence of total shocks, appropriate shocks, and inappropriate shocks.

Original languageEnglish (US)
Pages (from-to)1023-1029
Number of pages7
JournalJournal of Cardiovascular Electrophysiology
Volume22
Issue number9
DOIs
StatePublished - Sep 1 2011

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Shock
Incidence
Convulsive Therapy
Tachycardia
Equipment and Supplies
Survival
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Gilliam, F. Roosevelt ; Hayes, David L. ; Boehmer, John ; Day, John ; Heidenreich, Paul A. ; Seth, Milan ; Jones, Paul W. ; Stein, Kenneth M. ; Saxon, Leslie A. / Real world evaluation of dual-zone ICD and CRT-D programming compared to single-zone programming : The ALTITUDE REDUCES study. In: Journal of Cardiovascular Electrophysiology. 2011 ; Vol. 22, No. 9. pp. 1023-1029.
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abstract = "Tachycardia Detection, ICD, CRT-D Devices, Appropriate and Inappropriate Shock. Introduction: We evaluated the frequency of appropriate and inappropriate shocks and survival in patients using dual-zone programming versus single-zone programming. Methods and Results: For the ALTITUDE REDUCES study, patients were followed for 1.6 ± 1.1 years. The 12-month incidence of any shock was lower for dual-versus single-zone programmed detection at rates 200 bpm (P < 0.001). Appropriate shock rates at 1 year were also lower with dual-zone programming in these rate intervals (single zone 9.1{\%}, 5.4{\%}, P < 0.001, dual zone 6.7{\%}, 4.7{\%}, P < 0.02). There were no detectable differences between single- and dual-zone shock incidence at detection rates ≥ 200 bpm (P = 0.14). Inappropriate shock incidence was less with dual- versus single-zone detection at all detect rates <200 bpm, but not at rates ≥200 bpm (P < 0.001, P = 0.37). The lowest risk of appropriate and inappropriate shock was associated with dual-zone programming and detection rates ≥200 bpm (2.1{\%}). Dual-zone detection was associated with more nonsustained and diverted therapy episodes but these patients did not have an increased risk of death compared to patients with single-zone programming. Patients programmed to low detection rate, single-zone detection and shock-only therapy also had the highest preshock mortality risk (P = 0.05). Conclusions: Shock incidence is lowest with either single- or dual-zone detection ≥200 bpm. For detection rates <200 bpm, dual-zone programming is associated with a reduction in the incidence of total shocks, appropriate shocks, and inappropriate shocks.",
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Real world evaluation of dual-zone ICD and CRT-D programming compared to single-zone programming : The ALTITUDE REDUCES study. / Gilliam, F. Roosevelt; Hayes, David L.; Boehmer, John; Day, John; Heidenreich, Paul A.; Seth, Milan; Jones, Paul W.; Stein, Kenneth M.; Saxon, Leslie A.

In: Journal of Cardiovascular Electrophysiology, Vol. 22, No. 9, 01.09.2011, p. 1023-1029.

Research output: Contribution to journalArticle

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T1 - Real world evaluation of dual-zone ICD and CRT-D programming compared to single-zone programming

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AU - Gilliam, F. Roosevelt

AU - Hayes, David L.

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AU - Day, John

AU - Heidenreich, Paul A.

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N2 - Tachycardia Detection, ICD, CRT-D Devices, Appropriate and Inappropriate Shock. Introduction: We evaluated the frequency of appropriate and inappropriate shocks and survival in patients using dual-zone programming versus single-zone programming. Methods and Results: For the ALTITUDE REDUCES study, patients were followed for 1.6 ± 1.1 years. The 12-month incidence of any shock was lower for dual-versus single-zone programmed detection at rates 200 bpm (P < 0.001). Appropriate shock rates at 1 year were also lower with dual-zone programming in these rate intervals (single zone 9.1%, 5.4%, P < 0.001, dual zone 6.7%, 4.7%, P < 0.02). There were no detectable differences between single- and dual-zone shock incidence at detection rates ≥ 200 bpm (P = 0.14). Inappropriate shock incidence was less with dual- versus single-zone detection at all detect rates <200 bpm, but not at rates ≥200 bpm (P < 0.001, P = 0.37). The lowest risk of appropriate and inappropriate shock was associated with dual-zone programming and detection rates ≥200 bpm (2.1%). Dual-zone detection was associated with more nonsustained and diverted therapy episodes but these patients did not have an increased risk of death compared to patients with single-zone programming. Patients programmed to low detection rate, single-zone detection and shock-only therapy also had the highest preshock mortality risk (P = 0.05). Conclusions: Shock incidence is lowest with either single- or dual-zone detection ≥200 bpm. For detection rates <200 bpm, dual-zone programming is associated with a reduction in the incidence of total shocks, appropriate shocks, and inappropriate shocks.

AB - Tachycardia Detection, ICD, CRT-D Devices, Appropriate and Inappropriate Shock. Introduction: We evaluated the frequency of appropriate and inappropriate shocks and survival in patients using dual-zone programming versus single-zone programming. Methods and Results: For the ALTITUDE REDUCES study, patients were followed for 1.6 ± 1.1 years. The 12-month incidence of any shock was lower for dual-versus single-zone programmed detection at rates 200 bpm (P < 0.001). Appropriate shock rates at 1 year were also lower with dual-zone programming in these rate intervals (single zone 9.1%, 5.4%, P < 0.001, dual zone 6.7%, 4.7%, P < 0.02). There were no detectable differences between single- and dual-zone shock incidence at detection rates ≥ 200 bpm (P = 0.14). Inappropriate shock incidence was less with dual- versus single-zone detection at all detect rates <200 bpm, but not at rates ≥200 bpm (P < 0.001, P = 0.37). The lowest risk of appropriate and inappropriate shock was associated with dual-zone programming and detection rates ≥200 bpm (2.1%). Dual-zone detection was associated with more nonsustained and diverted therapy episodes but these patients did not have an increased risk of death compared to patients with single-zone programming. Patients programmed to low detection rate, single-zone detection and shock-only therapy also had the highest preshock mortality risk (P = 0.05). Conclusions: Shock incidence is lowest with either single- or dual-zone detection ≥200 bpm. For detection rates <200 bpm, dual-zone programming is associated with a reduction in the incidence of total shocks, appropriate shocks, and inappropriate shocks.

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