Predictors of Shock‐Reduction Programming and Its Impact on Implantable Cardioverter‐Defibrillator Therapies and Mortality: The CERTITUDE Registry
Background Shock‐reduction implantable cardioverter‐defibrillator programming (SRP) was associated with fewer therapies and improved survival in randomized controlled trials, but real‐world studies investigating SRP and associated outcomes are limited. Methods and Results The BIOTRONIK CERTITUDE reg...
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Wiley
2024-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.034500 |
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| author | Sebastian E. Beyer Camden Harrell Steven Mullane Valentina Kutyifa Malini Madhavan Jonathan P. Piccini Gaurav A. Upadhyay James E. Ip George Thomas Christopher F. Liu Steven M. Markowitz David Hayes Bruce B. Lerman Jim W. Cheung |
| author_facet | Sebastian E. Beyer Camden Harrell Steven Mullane Valentina Kutyifa Malini Madhavan Jonathan P. Piccini Gaurav A. Upadhyay James E. Ip George Thomas Christopher F. Liu Steven M. Markowitz David Hayes Bruce B. Lerman Jim W. Cheung |
| author_sort | Sebastian E. Beyer |
| collection | DOAJ |
| description | Background Shock‐reduction implantable cardioverter‐defibrillator programming (SRP) was associated with fewer therapies and improved survival in randomized controlled trials, but real‐world studies investigating SRP and associated outcomes are limited. Methods and Results The BIOTRONIK CERTITUDE registry was linked with the Medicare database. We included all patients with an implantable cardioverter‐defibrillator implanted between August 22, 2012 and September 30, 2021 in the United States. SRP was defined as programming to either a therapy rate cutoff ≥188 beats per minute or number of intervals to detection ≥30/40 for treatment. Among 6781 patients (mean 74±9 years; 27% women), 3393 (50%) had SRP. Older age, secondary prevention indication, and device implantation in the southern or western United States were associated with lower use of SRP. The cumulative incidence rate of implantable cardioverter‐defibrillator shocks was lower in the SRP group (5.1% shocks/patient year) compared with the non‐SRP group (7.2% shocks/patient year) (adjusted hazard ratio [HR], 0.83 [95% CI, 0.73–0.96]; P=0.005). Over a median follow‐up of 2.9 years, 739 deaths occurred in the SRP group and 822 deaths occurred in the non‐SRP group (adjusted HR, 0.97 [95% CI, 0.88–1.07]; P=0.569). SRP was associated with a lower all‐cause mortality among patients without ischemic heart disease compared with patients with ischemic heart disease (adjusted HR, 0.64 [95% CI, 0.48–0.87] versus adjusted HR, 1.02 [95% CI, 0.92–1.14]; Pinteraction=0.004). Conclusions Adoption of SRP is low in real‐world clinical practice. Age, clinical variables, and geographic factors are associated with use of SRP. In this study, SRP‐associated decrease in mortality was limited to patients without ischemic heart disease. |
| format | Article |
| id | doaj-art-722437324f3f40a781c7a97dd1e2eebf |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-722437324f3f40a781c7a97dd1e2eebf2025-08-20T02:11:42ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-08-01131510.1161/JAHA.124.034500Predictors of Shock‐Reduction Programming and Its Impact on Implantable Cardioverter‐Defibrillator Therapies and Mortality: The CERTITUDE RegistrySebastian E. Beyer0Camden Harrell1Steven Mullane2Valentina Kutyifa3Malini Madhavan4Jonathan P. Piccini5Gaurav A. Upadhyay6James E. Ip7George Thomas8Christopher F. Liu9Steven M. Markowitz10David Hayes11Bruce B. Lerman12Jim W. Cheung13Division of Cardiology, Department of Medicine, Weill Cornell Medicine, New York– Presbyterian Hospital New York NYBIOTRONIK Lake Oswego ORBIOTRONIK Lake Oswego ORDivision of Cardiology, Department of Medicine University of Rochester Medical Center Rochester NYDepartment of Cardiovascular Diseases, Mayo Clinic Rochester MNCardiac Electrophysiology Section, Division of Cardiology, Department of Medicine Duke University Medical Center Durham NCUniversity of Chicago Medicine, Center for Arrhythmia Care, Pritzker School of Medicine, Section of Cardiology Chicago ILDivision of Cardiology, Department of Medicine, Weill Cornell Medicine, New York– Presbyterian Hospital New York NYDivision of Cardiology, Department of Medicine, Weill Cornell Medicine, New York– Presbyterian Hospital New York NYDivision of Cardiology, Department of Medicine, Weill Cornell Medicine, New York– Presbyterian Hospital New York NYDivision of Cardiology, Department of Medicine, Weill Cornell Medicine, New York– Presbyterian Hospital New York NYBIOTRONIK Lake Oswego ORDivision of Cardiology, Department of Medicine, Weill Cornell Medicine, New York– Presbyterian Hospital New York NYDivision of Cardiology, Department of Medicine, Weill Cornell Medicine, New York– Presbyterian Hospital New York NYBackground Shock‐reduction implantable cardioverter‐defibrillator programming (SRP) was associated with fewer therapies and improved survival in randomized controlled trials, but real‐world studies investigating SRP and associated outcomes are limited. Methods and Results The BIOTRONIK CERTITUDE registry was linked with the Medicare database. We included all patients with an implantable cardioverter‐defibrillator implanted between August 22, 2012 and September 30, 2021 in the United States. SRP was defined as programming to either a therapy rate cutoff ≥188 beats per minute or number of intervals to detection ≥30/40 for treatment. Among 6781 patients (mean 74±9 years; 27% women), 3393 (50%) had SRP. Older age, secondary prevention indication, and device implantation in the southern or western United States were associated with lower use of SRP. The cumulative incidence rate of implantable cardioverter‐defibrillator shocks was lower in the SRP group (5.1% shocks/patient year) compared with the non‐SRP group (7.2% shocks/patient year) (adjusted hazard ratio [HR], 0.83 [95% CI, 0.73–0.96]; P=0.005). Over a median follow‐up of 2.9 years, 739 deaths occurred in the SRP group and 822 deaths occurred in the non‐SRP group (adjusted HR, 0.97 [95% CI, 0.88–1.07]; P=0.569). SRP was associated with a lower all‐cause mortality among patients without ischemic heart disease compared with patients with ischemic heart disease (adjusted HR, 0.64 [95% CI, 0.48–0.87] versus adjusted HR, 1.02 [95% CI, 0.92–1.14]; Pinteraction=0.004). Conclusions Adoption of SRP is low in real‐world clinical practice. Age, clinical variables, and geographic factors are associated with use of SRP. In this study, SRP‐associated decrease in mortality was limited to patients without ischemic heart disease.https://www.ahajournals.org/doi/10.1161/JAHA.124.034500implantable cardioverter‐defibrillator programmingmortalityshock‐reduction programming |
| spellingShingle | Sebastian E. Beyer Camden Harrell Steven Mullane Valentina Kutyifa Malini Madhavan Jonathan P. Piccini Gaurav A. Upadhyay James E. Ip George Thomas Christopher F. Liu Steven M. Markowitz David Hayes Bruce B. Lerman Jim W. Cheung Predictors of Shock‐Reduction Programming and Its Impact on Implantable Cardioverter‐Defibrillator Therapies and Mortality: The CERTITUDE Registry Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease implantable cardioverter‐defibrillator programming mortality shock‐reduction programming |
| title | Predictors of Shock‐Reduction Programming and Its Impact on Implantable Cardioverter‐Defibrillator Therapies and Mortality: The CERTITUDE Registry |
| title_full | Predictors of Shock‐Reduction Programming and Its Impact on Implantable Cardioverter‐Defibrillator Therapies and Mortality: The CERTITUDE Registry |
| title_fullStr | Predictors of Shock‐Reduction Programming and Its Impact on Implantable Cardioverter‐Defibrillator Therapies and Mortality: The CERTITUDE Registry |
| title_full_unstemmed | Predictors of Shock‐Reduction Programming and Its Impact on Implantable Cardioverter‐Defibrillator Therapies and Mortality: The CERTITUDE Registry |
| title_short | Predictors of Shock‐Reduction Programming and Its Impact on Implantable Cardioverter‐Defibrillator Therapies and Mortality: The CERTITUDE Registry |
| title_sort | predictors of shock reduction programming and its impact on implantable cardioverter defibrillator therapies and mortality the certitude registry |
| topic | implantable cardioverter‐defibrillator programming mortality shock‐reduction programming |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.034500 |
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