• Valentina Kutyifa, Arthur J Moss, Claudio Schuger, Scott McNitt, Bronislava Polonsky, Ruwald Anne-Christine H AH University of Rochester Medical Center, Rochester, New York, USA., Martin H Ruwald, James P Daubert, and Wojciech Zareba.
• University of Rochester Medical Center, Rochester, New York, USA.
• J. Cardiovasc. Electrophysiol. 2015 Aug 1; 26 (8): 879-884.

BackgroundThere are limited data whether history of atrial tachyarrhythmia (AT) modifies the risk of inappropriate ICD therapy, or the efficacy of novel ICD programming to reduce inappropriate ICD therapy events.MethodsIn MADIT-RIT, we investigated the effects of novel ICD programming with high-rate cut-off VT zone ≥ 200 bpm (arm B), or 60-second delayed therapy in the VT zone 170-199 bpm (arm C), compared to conventional programming VT zone>170 bpm (arm A) on first inappropriate ICD therapy in those with or those without AT prior to enrollment.ResultsIn patients with prior AT (n = 203, 14%) there was a higher risk of inappropriate ICD therapy (HR = 2.10, 95% CI: 1.38-3.20, P < 0.001), and inappropriate ICD shock (HR = 2.56, 95% CI: 1.38-4.74, P = 0.003) compared to those with no prior AT. The effects of innovative programming to reduce inappropriate ICD therapy with either high-rate cut-off or delayed VT therapy were similar in patients with prior AT (arm B vs. A HR = 0.11, P < 0.001, arm C vs. A HR = 0.17, P < 0.001), and also in patients without prior AT before enrollment (arm B vs. A HR = 0.15, P < 0.001, arm C vs. A HR = 0.24, P < 0.001, interaction P-values >0.10 for all).ConclusionsNovel ICD programming with a high-rate cut-off or delayed therapy is equally beneficial to reduce inappropriate ICD therapy in patients with or without prior AT, despite the lower risk of inappropriate ICD therapy in patients without prior AT.© 2015 Wiley Periodicals, Inc.

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