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2019 HRS/EHRA/APHRS/LAHRS focused update to 2015 expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing
- Source :
- Journal of Interventional Cardiac Electrophysiology, Journal of Arrhythmia, Vol 35, Iss 3, Pp 485-493 (2019)
- Publication Year :
- 2019
-
Abstract
- The 2015 HRS/EHRA/APHRS/SOLAECE Expert Consensus Statement on Optimal Implantable Cardioverter-Defibrillator Programming and Testing provided guidance on bradycardia programming, tachycardia detection, tachycardia therapy, and defibrillation testing for implantable cardioverter-defibrillator (ICD) patient treatment. The 32 recommendations represented the consensus opinion of the writing group, graded by Class of Recommendation and Level of Evidence. In addition, Appendix B provided manufacturer-specific translations of these recommendations into clinical practice consistent with the recommendations within the parent document. In some instances, programming guided by quality evidence gained from studies performed in devices from some manufacturers was translated such that this programming was approximated in another manufacturer’s ICD programming settings. The authors found that the data, although not formally tested, were strong, consistent, and generalizable beyond the specific manufacturer and model of ICD. As expected, because these recommendations represented strategic choices to balance risks, there have been reports in which adverse outcomes were documented with ICDs programmed to Appendix B recommendations. The recommendations have been reviewed and updated to minimize such adverse events. Notably, patients who do not receive unnecessary ICD therapy are not aware of being spared potential harm, whereas patients in whom their ICD failed to treat life-threatening arrhythmias have their event recorded in detail. The revised recommendations employ the principle that the randomized trials and large registry data should guide programming more than anecdotal evidence. These recommendations should not replace the opinion of the treating physician who has considered the patient’s clinical status and desired outcome via a shared clinical decision-making process.
- Subjects :
- lcsh:Diseases of the circulatory (Cardiovascular) system
Death, Sudden, Cardiac/prevention & control
medicine.medical_treatment
Defibrillation testing
030204 cardiovascular system & hematology
law.invention
0302 clinical medicine
Randomized controlled trial
law
Tachycardia, Ventricular/diagnosis
030212 general & internal medicine
Anecdotal evidence
Societies, Medical
Event (computing)
Arrhythmias, Cardiac/diagnosis
Antitachycardia pacing
Implantable cardioverter-defibrillator
Defibrillators, Implantable
Programming
Medical emergency
Cardiology and Cardiovascular Medicine
Algorithms
Ventricular Fibrillation/diagnosis
Consensus
Defibrillation
Cardiology
Electric Countershock
Guidelines
Article
03 medical and health sciences
Physiology (medical)
medicine
Bradycardia
Tachycardia detection
Humans
Cardiac Resynchronization Therapy Devices
Tachycardia therapy
Ventricular fibrillation
Adverse effect
Retrospective Studies
Statement (computer science)
business.industry
Bradycardia mode and rate
Ventricular tachycardia
Arrhythmias, Cardiac
Evidence-based medicine
medicine.disease
Sudden cardiac death
lcsh:RC666-701
Bradycardia/diagnosis
Tachycardia, Ventricular
business
Software
Implantable cardioverter‐defibrillator
Subjects
Details
- ISSN :
- 15563871
- Volume :
- 17
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Heart rhythm
- Accession number :
- edsair.doi.dedup.....3d8744d28036c638771c2f42854a5530