Algorithms and programming matters: implantable cardioverter defibrillator therapy in Biotronik and Abbott devices

Excerpt

Implantable cardioverter defibrillators (ICDs) are considered the gold standard for the prevention of sudden cardiac death in high-risk individuals. Treating an episode of sustained malignant ventricular arrhythmia (ventricular tachycardia [VT] or ventricular fibrillation [VF]) with anti-tachycardia pacing (ATP) or electrical shocks is the only option for restoring viable hemodynamics. On the other hand, the latest guidelines recommendations, based on numerous randomized trials, suggest the need to avoid treating slower and organized ventricular arrhythmias too prematurely or too aggressively, and to avoid the treatment of non-ventricular tachyarrhythmias [1]. VT/VF therapies can save a life when applied correctly, but it is also associated with a deleterious effect, a reduction in quality of life, and increased mortality on its own and should therefore be avoided whenever possible, especially when spontaneous termination is expected or when a less aggressive therapy can be effective [2]. …