Accurate Therapies

How can I reduce the use of shock therapy, without prolonging time to arrhythmia termination?

  • Inappropriate shocks are linked to anxiety and depression and continue to be a major source of distress to patients5

  • A Fib is the predominant cause of inappropriate shocks5 (A Fib prevalence in HF patients: 20-30%4)

  • ATP for Fast VT is highly effective and prevents painful shocks3, but can increase time to arrhythmia termination or cause unnecessary charges


Superior Specificity


PARAD+ is an enhancement of PARAD, which has been shown to have the best arrhythmia classification.1PARAD+ provides superior arrhythmia discrimination (94% specificity) to minimise inappropriate shocks2.

 

FVT Stability Analysis

No inappropriate ATP

No delay in case of VF

PARAD+

Click here to see the animation

 

Safe and Painless3

  • Antitachycardia pacing is programmable in three VT zones, slow VT, VT, and fast VT for painless therapy.

  • Autoswitch ATP: The last successful ATP therapy is applied as a priority
    Unnecessary charges are avoided when ATP is effective

  • Fast VTs stability is analysed allowing selection of ATP or shock therapy.

 

 

1. “After correction for the clinical prevalence of the simulated supraventricular tachyarrhythmias the specifi city was: ELA medical: 99%; Biotronic: 95%; Guidant: 94%, Medtronic: 93%, St Jude: 92%” Hintringer F et al: Comparison of the specifi city of implantable dual chamber defi brillator detection algorithms. PACE 2004;27:976-982.
2. Unique long cycle search criteria is used to avoid treating AF that is rapidly conducted to the ventricle, and thus limits inappropriate therapies for AF to 0.3% to 0.8%risk per patient. Mletzko R et al:Enhanced Specificity of a Dual Chamber ICD Arrhythmia Detection Algorithm by Rate Stability criteria. PACE 2004;27:1113-1119.
3. ”Empirical ATP is highly effective in treating FVT. It prevents painful shocks without any clinical difference in episode duration, arrhythmic syncope, acceleration, or sudden death while yielding improvement in QoL. The investigators of the PainFREE Rx II trial recommend ATP as the preferred therapy for FVT in most ICD patients.” Mark S. Wathen et al., Reduces Shock Therapies (PainFREE Rx II) Trial Results Implantable Cardioverter-Defibrillators: Pacing Fast Ventricular TachycardiaVersus Shocks for Spontaneous Rapid Ventricular Tachycardia in Patients With Prospective Randomized Multicenter Trial of Empirical Antitachycardia Pacing, Journal of the Amercian heart Association, Circulation 2004;110;2591-2596.
4. Kiès P et al. Cardiac resynchronisation therapy in chronic atrial fi brillation: impact on left atrial size and reversal to sinus rhythm. Heart. 2006 Apr;92(4):490-4. 5. Anselme F, et al.: Prevention of Inappropriate shocks in ICD Recipients: A review of 10000 Tachycardia Episodes. PACE 2007;30: Sup1.
5. Anselme F, et al.: Prevention of Inappropriate shocks in ICD Recipients: A review of 10000 Tachycardia Episodes. PACE 2007;30: Sup1.


Clinical Update

Clinical Cases

Slow Ventricular Tachycardia: A New Therapeutic Approach

Reviews

Minimizing RV Pacing with a New Pacing Algorithm for Implantable Pacemakers and Defibrillators: ADI Mode

Bibliography

Bibliography of references

Related Sites

American College of Cardiology

American Heart Association

Heart Rhythm Society

European Society of Cardiology

Heart Failure Matters