ICD programming

Abstract

Background: Appropriate ICD programming is the key to prevent inappropriate shock delivery, that is closely associated to a negative patients' outcome.

Methods: Review of the literature on ICD therapy to generate ICD programmings that can be applied to the broad population of ICD and CRT-D carriers.

Results: Arrhythmia detection should occur with a detection time ranging 9″-12″ in the VF zone, and 15″-60″ in the VT zone. Discriminator should be applied at least up to 200 bpm. ATP therapy is applied to all VTs up to 250 bpm, with a success rate of 70%. Inappropriate shocks should occur in <3.6% of patients.

Conclusion: Tailored ICD programming can be achieved following evidence from large ICD trials. Pre-defined settings that are saved on the programmer and that can be uploaded at device implantation help to ensure optimal programming and to avoid random errors.

Keywords: Arrhythmia detection; Arrhythmia discrimination; ICD programming; VF/VT treatment.