Four societies release collaborative expert consensus statement on ICD programming and testing

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Bruce Wilkoff
Bruce Wilkoff

An expert consensus statement on recommendations for programming choices in the implementation of implantable cardioverter-defibrillator (ICD) therapy has been presented at the Asia Pacific Heart Rhythm Society’s 8th Scientific Sessions.

The statement-the 2015 HRS/EHRA/APHRS/SOLAECE Expert Consensus Statement on Optimal Implantable Cardioverter-Defibrillator Programming and Testing-has been release by The Heart Rhythm Society (HRS), European Heart Rhythm Association (EHRA), Asia Pacific Heart Rhythm Society (APHRS), and the Socieded Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE).

According to a press release, the expert statement systemically describes four important clinical issues and addresses programming of:

  • Bradycardia mode and rate
  • Tachycardia detection
  • Tachycardia therapy
  • Intraprocedural testing of defibrillation efficacy

“This new expert consensus statement provides a much needed single set of recommendations that clinicians from around the world can consult,” says Bruce Wilkoff, chair, Cleveland Clinic, Cleveland, Ohio. “When national or regional societies provide recommendations, they are potentially conflicting and confusing to physicians. This collaborative consensus provides a global set of recommendations which allows clinicians, no matter where they provide care, to improve the safety and lives of their patients living with an ICD.”

The consensus statement provides a review of the field and reports the recommendations of a writing group comprised of international experts. The consensus statement includes 32 distinctive recommendations which were approved by an average of 96% of the 35 writing committee members.

“It’s been incredible to work with four leading electrophysiology societies on this very important issue,” says Martin Stiles, co-chair, Waikato Hospital, Hamilton, New Zealand. “Not only have we come up with specific recommendations for clinicians, but now we have sufficient data to support recommendations that improve the safety of patients living with ICDs, which will help advance overall patient care.”

The consensus statement also includes the writing committee’s translations specific to each ICD manufacturer and is intended to best approximate the recommended behaviors for each available ICD model. The authors note that the care of individual patients must be provided in context of their specific clinical condition as well as the data available on the patient. As an individual patient’s condition changes or progresses and additional clinical considerations become apparent, the programming of their ICDs must reflect those changes. Remote and in-person interrogations of the ICD and clinical monitoring must continue to inform programming choices made for each patient.

The consensus document is available on the HRS website and will also be published in HeartRhythm, the official Journal of HRS, in early 2016.

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