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Assessing therapies

Classifications

Appropriate

•VT/VF

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Inappropriate

•SVTs

•Noise

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Unnecessary

•NSVTs

Shocks

ICD shocks are associated with a lower quality of life (sears et al., 2005)


Receiving ICD shocks may be a risk for other morbidities and mortality

•Appropriate and inappropriate shocks are associated with higher mortality in heart failure patients (Poole et al., 2008)

•Findings have shown receiving shocks results in a subsequent 2-5 fold increased risk of death (MADIT II & SCD-HEFT)

•Even receiving 1 shock is associated with increased mortality risk, and risk increases with subsequent shocks (Borne et al., 2013; Van Rees et al., 2011)

Inappropriate shocks

Inappropriate shocks used to be reportedly as high as 13-17%


More recent analysis have shown inappropriate shocks 6.4%/annum


Some studies suggest <2% risk of inappropriate shocks when longer detections are utilised

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Causes include

•Oversensing and

•Atrially driven arrhythmias

•AF

•STc

•ATc

•AFl

•SVT

•AVRT

•AVNRT

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