The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
Reduction in Inappropriate Therapy and Mortality through ICD Programming
Open accessAbstract
BACKGROUND: The implantable cardioverter-defibrillator (ICD) is highly effective in reducing mortality among patients at risk for fatal arrhythmias, but inappropriate ICD activations are frequent, with potential adverse effects. METHODS: We randomly assigned 1500 patients with a primary-prevention indication to receive an ICD with one of three programming configurations. The primary objective was to determine whether programmed high-rate therapy (with a 2.5-second delay before the initiation of therapy at a heart rate of ≥200 beats per minute) or delayed therapy (with a 60-second delay at 170 to 199 beats per minute, a 12-second delay at 200 to 249 beats per minute, and a 2.5-second delay at ≥250 beats per minute) was associated with a decrease in the number of patients with a first occurrence of inappropriate antitachycardia pacing or shocks, as compared with conventional programming (with a 2.5-second delay at 170 to 199 beats per minute and a 1.0-second delay at ≥200 beats per minute). RESULTS: During an average follow-up of 1.4 years, high-rate therapy and delayed ICD therapy, as compared with conventional device programming, were associated with reductions in a first occurrence of inappropriate therapy (hazard ratio with high-rate therapy vs. conventional therapy, 0.21; 95% confidence interval [CI], 0.13 to 0.34; P<0.001; hazard ratio with delayed therapy vs. conventional therapy, 0.24; 95% CI, 0.15 to 0.40; P<0.001) and reductions in all-cause mortality (hazard ratio with high-rate therapy vs. conventional therapy, 0.45; 95% CI, 0.24 to 0.85; P=0.01; hazard ratio with delayed therapy vs. conventional therapy, 0.56; 95% CI, 0.30 to 1.02; P=0.06). There were no significant differences in procedure-related adverse events among the three treatment groups. CONCLUSIONS: Programming of ICD therapies for tachyarrhythmias of 200 beats per minute or higher or with a prolonged delay in therapy at 170 beats per minute or higher, as compared with conventional programming, was associated with reductions in inappropriate therapy and all-cause mortality during long-term follow-up. (Funded by Boston Scientific; MADIT-RIT ClinicalTrials.gov number, NCT00947310.).
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Self-citationAmiodarone or an Implantable Cardioverter–Defibrillator for Congestive Heart Failure
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Metadata
- Authors
- Moss, A. J., Schuger, C., Beck, C. A., Brown, M. W., Cannom, D. S., Daubert, J. P., Estes, N. A. M., Greenberg, H., Hall, W. J., Huang, D. T., Kautzner, J., Klein, H., McNitt, S., Olshansky, B., Shoda, M., Wilber, D., & Zareba, W.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2012-12-13
- Volume
- 367
- Issue
- 24
- Pages
- 2275-2283
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2108062940
- Cited by
- 1,378
- References
- 23
- FWCI
- 73.28
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Moss, A. J., Schuger, C., Beck, C. A., Brown, M. W., Cannom, D. S., Daubert, J. P., Estes, N. A. M., Greenberg, H., Hall, W. J., Huang, D. T., Kautzner, J., Klein, H., McNitt, S., Olshansky, B., Shoda, M., Wilber, D., & Zareba, W. (2012). Reduction in Inappropriate Therapy and Mortality through ICD Programming. New England Journal of Medicine. https://doi.org/10.1056/nejmoa1211107
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