Frequency of Inappropriate Therapy in Patients Implanted with Dual- Versus Single-Chamber ICD Devices in the ICD Arm of MADIT-CRT JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY Ruwald, A. H., Sood, N., Ruwald, M. H., Jons, C., Clyne, C. A., McNitt, S., Wang, P., Zareba, W., Moss, A. J. 2013; 24 (6): 672-679


The majority of implantable cardioverter defibrillators (ICDs) are dual-chamber devices, but studies on the frequency of inappropriate therapy in dual- versus single-chamber devices have shown conflicting results. The aim of this study is to determine whether implantation of dual-chamber ICD devices decrease the incidence of inappropriate therapy without an unacceptable increase in complications.In the ICD arm of the MADIT-CRT study (N = 704), comparisons of single- versus dual-chamber ICD devices were investigated on the endpoints of inappropriate therapy (antitachycardia pacing [ATP] and shocks) and device- and procedure-related complications by use of multivariate Cox proportional hazard regression analysis (hazard ratio dual:single chamber) adjusting for relevant covariates.The frequency of inappropriate therapies in single- and dual-chamber recipients was 41/294 (14%) and 50/410 (12%), respectively. There was no significant difference in overall inappropriate therapy (hazard ratio [HR] = 0.95 [CI: 0.63-1.45], P = 0.95) or inappropriate ATP (HR = 0.98 [CI: 0.61-1.58], P = 0.94), between single- and dual-chamber devices, using single-chamber as a reference (Dual:Single). However, there was a trend toward a decrease in inappropriate shocks (HR = 0.60 [CI: 0.34-1.08], P = 0.09) in the dual-chamber group. The same was evident when only analyzing inappropriate therapy for atrial tachyarrhythmias (HR = 0.88 [CI: 0.56-1.38], P = 0.58). There was no significant difference between the groups in device- or procedure-related complications (HR = 1.54 [CI: 0.82-2.90], P = 0.18).No significant difference was found in inappropriate therapy or complications in patients treated with single- versus dual-chamber ICD devices.

View details for DOI 10.1111/jce.12099

View details for Web of Science ID 000319898500011

View details for PubMedID 23445493