MELBOURNE, AUSTRALIA – 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) release the 2015 HRS/EHRA/APHRS/SOLAECE Expert Consensus Statement on Optimal Implantable Cardioverter-Defibrillator Programming and Testing. The expert consensus statement, presented today at the Asia Pacific Heart Rhythm Society’s 8th Scientific Sessions, represents the first global collaborative and comprehensive statement of recommendations on programming choices in the implementation of implantable cardioverter-defibrillator (ICD) therapy.
The benefits and risks of ICD therapy for patients are directly impacted by the programming and surgical decisions made by the clinician. The expert consensus statement systemically describes four important clinical issues and addresses programming of:
- Bradycardia mode and rate
- Tachycardia detection
- Tachycardia therapy
- Intraprocedural testing of defibrillation efficacy
“Making strategic programming choices when implementing ICD therapy is quite complex. This new expert consensus statement provides a much needed single set of recommendations that clinicians from around the world can consult,” said Bruce Wilkoff, MD, FHRS, CCDS, Chair, Cleveland Clinic in 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 state of the art 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 percent of the 35 writing committee members.
“It’s been incredible to work with four leading electrophysiology societies on this very important issue,” said Martin Stiles, MBChB, PhD, FHRS, co-Chair, Waikato Hospital in 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.
ICDs are devices that are about the size of a mobile phone and are implanted under the collarbone or below the armpit in a pocket under the skin. ICDs continuously monitor the heart rhythm, automatically function as pacemakers for heart rates that are too slow, and deliver life-saving shocks if a dangerously fast heart rhythm is detected. ICDs are very effective in stopping life-threatening arrhythmias and considered one of the most successful therapies to treat arrhythmias.
The consensus statement is developed in partnership and endorsed by HRS, EHRA, APHRS, and SOLAECE. To view the full document, please click here . The consensus statement will also be published in HeartRhythm, the official Journal of the Heart Rhythm Society, in early 2016.