First inappropriate implantable cardioverter defibrillator therapy is often due to inaccurate device programming: analysis of the French OPERA registry.
Identifieur interne : 000086 ( Hal/Curation ); précédent : 000085; suivant : 000087First inappropriate implantable cardioverter defibrillator therapy is often due to inaccurate device programming: analysis of the French OPERA registry.
Auteurs : Antoine Leenhardt [France] ; Pascal Defaye [France] ; Elisabeth Mouton ; Marc Delay ; Nicolas Delarche ; Jean-Marc Dupuis ; Olivier Bizeau ; Philippe Mabo [France] ; Saida Cheggour ; Dominique BabutySource :
- EP-Europace [ 1099-5129 ] ; 2012-10.
English descriptors
- mix :
Abstract
AIMS: Inappropriate therapy delivered by implantable cardioverter defibrillators (ICDs) remains a challenge. The OPERA registry measured the times to, and studied the determinants of, first appropriate (FAT) and inappropriate (FIT) therapies delivered by single-, dual- and triple-chamber [cardiac resynchronization therapy defibrillator (CRT-D)] ICD. METHODS AND RESULTS: We entered 636 patients (mean age = 62.0 ± 13.5 years; 88% men) in the registry, of whom 251 received single-, 238 dual-, and 147 triple-chamber ICD, for primary (30.5%) or secondary (69.5%) indications. We measured times to FAT and FIT as a function of multiple clinical characteristics, examined the effects of various algorithm components on the likelihood of FAT and FIT delivery, and searched for predictors of FAT and FIT. Over 22.8 ± 8.8 months of observation, 184 patients (28.9%) received FAT and 70 (11.0%) received FIT. Ventricular tachycardia (VT) was the trigger of 88% of FAT, and supraventricular tachycardia was the trigger of 91% of FIT. The median times to FIT (90 days; range 49-258) and FAT (171 days; 50-363) were similar. The rate of FAT was higher (P <0.001) in patients treated for secondary than primary indications, while that of FIT were similar in both groups. Out of 57 analysable FIT, 27 (47.4%) could have been prevented by fine tuning the device programming like the sustained rate duration or the VT discrimination algorithm. CONCLUSIONS: First inappropriate therapy occurred in 11% of 636 ICD recipients followed for ∼2 years. Nearly 50% of FIT could have been prevented by improving device programming.
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The OPERA registry measured the times to, and studied the determinants of, first appropriate (FAT) and inappropriate (FIT) therapies delivered by single-, dual- and triple-chamber [cardiac resynchronization therapy defibrillator (CRT-D)] ICD. METHODS AND RESULTS: We entered 636 patients (mean age = 62.0 ± 13.5 years; 88% men) in the registry, of whom 251 received single-, 238 dual-, and 147 triple-chamber ICD, for primary (30.5%) or secondary (69.5%) indications. We measured times to FAT and FIT as a function of multiple clinical characteristics, examined the effects of various algorithm components on the likelihood of FAT and FIT delivery, and searched for predictors of FAT and FIT. Over 22.8 ± 8.8 months of observation, 184 patients (28.9%) received FAT and 70 (11.0%) received FIT. Ventricular tachycardia (VT) was the trigger of 88% of FAT, and supraventricular tachycardia was the trigger of 91% of FIT. The median times to FIT (90 days; range 49-258) and FAT (171 days; 50-363) were similar. The rate of FAT was higher (P <0.001) in patients treated for secondary than primary indications, while that of FIT were similar in both groups. Out of 57 analysable FIT, 27 (47.4%) could have been prevented by fine tuning the device programming like the sustained rate duration or the VT discrimination algorithm. CONCLUSIONS: First inappropriate therapy occurred in 11% of 636 ICD recipients followed for ∼2 years. Nearly 50% of FIT could have been prevented by improving device programming.</div></front></TEI><hal api="V3"><titleStmt><title xml:lang="en">First inappropriate implantable cardioverter defibrillator therapy is often due to inaccurate device programming: analysis of the French OPERA registry.</title><author role="crp"><persName><forename type="first">Antoine</forename><surname>Leenhardt</surname></persName><email>antoine.leenhardt@bch.aphp.fr</email><idno type="halauthor">943707</idno><affiliation ref="#struct-209011"></affiliation></author><author role="aut"><persName><forename type="first">Pascal</forename><surname>Defaye</surname></persName><email></email><idno type="halauthor">407272</idno><affiliation ref="#struct-94817"></affiliation></author><author role="aut"><persName><forename type="first">Elisabeth</forename><surname>Mouton</surname></persName><email></email><idno type="halauthor">943708</idno></author><author role="aut"><persName><forename type="first">Marc</forename><surname>Delay</surname></persName><email></email><idno type="halauthor">632171</idno></author><author role="aut"><persName><forename type="first">Nicolas</forename><surname>Delarche</surname></persName><email></email><idno type="halauthor">943709</idno></author><author role="aut"><persName><forename type="first">Jean-Marc</forename><surname>Dupuis</surname></persName><email></email><idno type="halauthor">96982</idno></author><author role="aut"><persName><forename type="first">Olivier</forename><surname>Bizeau</surname></persName><email></email><idno type="halauthor">943710</idno></author><author role="aut"><persName><forename type="first">Philippe</forename><surname>Mabo</surname></persName><email></email><idno type="halauthor">163655</idno><affiliation ref="#struct-29417"></affiliation></author><author role="aut"><persName><forename type="first">Saida</forename><surname>Cheggour</surname></persName><email></email><idno type="halauthor">943711</idno></author><author role="aut"><persName><forename type="first">Dominique</forename><surname>Babuty</surname></persName><email></email><idno type="halauthor">781522</idno></author><editor role="depositor"><persName><forename>Morgane</forename><surname>Le Corre</surname></persName><email>laurent.jonchere@univ-rennes1.fr</email></editor></titleStmt><editionStmt><edition n="v1" type="current"><date type="whenSubmitted">2013-11-15 15:19:37</date><date type="whenModified">2013-11-15 15:19:37</date><date type="whenReleased">2013-11-15 15:19:37</date><date type="whenProduced">2012-10</date></edition><respStmt><resp>contributor</resp><name key="186196"><persName><forename>Morgane</forename><surname>Le Corre</surname></persName><email>laurent.jonchere@univ-rennes1.fr</email></name></respStmt></editionStmt><publicationStmt><distributor>CCSD</distributor><idno type="halId">hal-00904932</idno><idno type="halUri">https://hal.archives-ouvertes.fr/hal-00904932</idno><idno type="halBibtex">leenhardt:hal-00904932</idno><idno type="halRefHtml">EP-Europace, Oxford University Press (OUP): Policy B, 2012, 14 (10), pp.1465-74. <10.1093/europace/eus144></idno><idno type="halRef">EP-Europace, Oxford University Press (OUP): Policy B, 2012, 14 (10), pp.1465-74. <10.1093/europace/eus144></idno></publicationStmt><seriesStmt><idno type="stamp" n="UNIV-PARIS7">Université Denis Diderot - Paris VII</idno><idno type="stamp" n="UNIV-RENNES1">Université de Rennes 1</idno><idno type="stamp" n="CARDIO" p="INSERM">Cardiovasculaire</idno><idno type="stamp" n="HL">Publications CHU - Rennes 1</idno><idno type="stamp" n="LTSI">Laboratoire Traitement du Signal et de l'Image</idno></seriesStmt><notesStmt><note type="audience" n="2">International</note><note type="popular" n="0">No</note><note type="peer" n="1">Yes</note></notesStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">First inappropriate implantable cardioverter defibrillator therapy is often due to inaccurate device programming: analysis of the French OPERA registry.</title><author role="crp"><persName><forename type="first">Antoine</forename><surname>Leenhardt</surname></persName><email>antoine.leenhardt@bch.aphp.fr</email><idno type="halAuthorId">943707</idno><affiliation ref="#struct-209011"></affiliation></author><author role="aut"><persName><forename type="first">Pascal</forename><surname>Defaye</surname></persName><idno type="halAuthorId">407272</idno><affiliation ref="#struct-94817"></affiliation></author><author role="aut"><persName><forename type="first">Elisabeth</forename><surname>Mouton</surname></persName><idno type="halAuthorId">943708</idno></author><author role="aut"><persName><forename type="first">Marc</forename><surname>Delay</surname></persName><idno type="halAuthorId">632171</idno></author><author role="aut"><persName><forename type="first">Nicolas</forename><surname>Delarche</surname></persName><idno type="halAuthorId">943709</idno></author><author role="aut"><persName><forename type="first">Jean-Marc</forename><surname>Dupuis</surname></persName><idno type="halAuthorId">96982</idno></author><author role="aut"><persName><forename type="first">Olivier</forename><surname>Bizeau</surname></persName><idno type="halAuthorId">943710</idno></author><author role="aut"><persName><forename type="first">Philippe</forename><surname>Mabo</surname></persName><idno type="halAuthorId">163655</idno><affiliation ref="#struct-29417"></affiliation></author><author role="aut"><persName><forename type="first">Saida</forename><surname>Cheggour</surname></persName><idno type="halAuthorId">943711</idno></author><author role="aut"><persName><forename type="first">Dominique</forename><surname>Babuty</surname></persName><idno type="halAuthorId">781522</idno></author></analytic><monogr><idno type="halJournalId" status="VALID">22254</idno><idno type="issn">1099-5129</idno><idno type="eissn">1532-2092</idno><title level="j">EP-Europace</title><imprint><publisher>Oxford University Press (OUP): Policy B</publisher><biblScope unit="volume">14</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="pp">1465-74</biblScope><date type="datePub">2012-10</date><date type="dateEpub">2012-04-29</date></imprint></monogr><idno type="doi">10.1093/europace/eus144</idno><idno type="pubmed">22547767</idno></biblStruct></sourceDesc><profileDesc><langUsage><language ident="en">English</language></langUsage><textClass><keywords scheme="author"><term xml:lang="en">Implantable cardioverter defibrillator</term><term xml:lang="en">Inappropriate therapy</term><term xml:lang="en">Ventricular tachyarrhythmia</term><term xml:lang="en">Supraventricular tachyarrhythmia</term><term xml:lang="en">Atrial fibrillation</term></keywords><classCode scheme="mesh">Aged</classCode><classCode scheme="mesh">Algorithms</classCode><classCode scheme="mesh">Prosthesis Failure</classCode><classCode scheme="mesh">Registries</classCode><classCode scheme="mesh">Tachycardia, Supraventricular</classCode><classCode scheme="mesh">Tachycardia, Ventricular</classCode><classCode scheme="mesh">Treatment Outcome</classCode><classCode scheme="mesh">Cardiac Resynchronization Therapy</classCode><classCode scheme="mesh">Defibrillators, Implantable</classCode><classCode scheme="mesh">Female</classCode><classCode scheme="mesh">France</classCode><classCode scheme="mesh">Humans</classCode><classCode scheme="mesh">Incidence</classCode><classCode scheme="mesh">Male</classCode><classCode scheme="mesh">Middle Aged</classCode><classCode scheme="halDomain" n="sdv.ib">Life Sciences [q-bio]/Bioengineering</classCode><classCode scheme="halDomain" n="sdv.mhep.csc">Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system</classCode><classCode scheme="halTypology" n="ART">Journal articles</classCode></textClass><abstract xml:lang="en">AIMS: Inappropriate therapy delivered by implantable cardioverter defibrillators (ICDs) remains a challenge. The OPERA registry measured the times to, and studied the determinants of, first appropriate (FAT) and inappropriate (FIT) therapies delivered by single-, dual- and triple-chamber [cardiac resynchronization therapy defibrillator (CRT-D)] ICD. METHODS AND RESULTS: We entered 636 patients (mean age = 62.0 ± 13.5 years; 88% men) in the registry, of whom 251 received single-, 238 dual-, and 147 triple-chamber ICD, for primary (30.5%) or secondary (69.5%) indications. We measured times to FAT and FIT as a function of multiple clinical characteristics, examined the effects of various algorithm components on the likelihood of FAT and FIT delivery, and searched for predictors of FAT and FIT. Over 22.8 ± 8.8 months of observation, 184 patients (28.9%) received FAT and 70 (11.0%) received FIT. Ventricular tachycardia (VT) was the trigger of 88% of FAT, and supraventricular tachycardia was the trigger of 91% of FIT. The median times to FIT (90 days; range 49-258) and FAT (171 days; 50-363) were similar. The rate of FAT was higher (P <0.001) in patients treated for secondary than primary indications, while that of FIT were similar in both groups. Out of 57 analysable FIT, 27 (47.4%) could have been prevented by fine tuning the device programming like the sustained rate duration or the VT discrimination algorithm. CONCLUSIONS: First inappropriate therapy occurred in 11% of 636 ICD recipients followed for ∼2 years. Nearly 50% of FIT could have been prevented by improving device programming.</abstract><particDesc><org type="consortium">OPERA Registry investigators</org></particDesc></profileDesc></hal></record>Pour manipuler ce document sous Unix (Dilib)
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