Cardiology Medical News about simplified biventricular defibrillator;heart failure

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A simplified biventricular defibrillator with fixed long detection intervals reduces implantable cardioverter defibrillator (ICD) interventions and heart failure hospitalizations in patients with non-ischaemic cardiomyopathy implanted for primary prevention: the RELEVANT [Role of long dEtection window programming in patients with LEft VentriculAr dysfunction, Non-ischemic eTiology in primary prevention treated with a biventricular ICD] study
European Heart Journal, 07/02/09

Gasparini M et al. – A simplified cardioverter–defibrillator (CRT-D) device with fixed long detection reduced overall implantable cardioverter defibrillator (ICD) therapy burden and heart failure (HF) hospitalizations without entailing any additional adverse events in primary prevention non-ischemic HF pts.

Methods

Study of the efficacy and safety of a cardiac resynchronization therapy with CRT-D device with simplified ventricular tachycardia management in pts with non-ischemic HF and primary prevention ICD indication
Prospective, controlled, parallel, multi-center, non-randomized study enrolling 324 primary prevention non-ischemic HF pts implanted with CRT-D devices from 2004-2007
Protect group: 164 pts implanted with Medtronic Insync III Protect device
Control group: 160 pts using other Medtronic CRT-D devices
Efficacy assessment by computing appropriate and inappropriate detections and therapies during follow-up
Safety assessment by comparing hospitalizations and syncopal events between groups

Results

With the Protect algorithm, 90% of both ventricular and supraventricular tachyarrhythmias terminated within 13–29 beat detection interval
Protect group had significantly better event-free survival to first delivered therapy for total, appropriately treated, and inappropriately treated episodes
Total number of delivered shocks significantly lower in Protect group (22 vs 59)
In Protect group, significantly reduced HF hospitalization without any increase of syncope or death

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