Landmark study could lead to fewer inappropriate shocks from implanted defibrillators

Published on November 8, 2012 at 6:07 AM · No Comments

Loyola University Medical Center is among the centers participating in a landmark study that could lead to fewer inappropriate shocks from implanted defibrillators.

Implanted defibrillators save lives by shocking hearts back into a normal rhythm. But sometimes a defibrillator can go off when it's not necessary, delivering a shock that feels like a kick in the chest.

The study found that reprogramming defibrillators to be less sensitive to irregular heart rhythms reduced the number of inappropriate shocks, while also reducing mortality. The study was presented at a meeting of the American Heart Association Scientific Sessions and is being published in the New England Journal of Medicine.

"Inappropriate shocks can be painful and psychologically traumatic to patients," said cardiologist Dr. Peter Santucci, medical director of Loyola's Implant Device Program. "It's important to reduce these shocks, and results of this study will help us to do this, while also potentially improving patients' survival."

Santucci enrolled Loyola patients in the multi-center international trial. Dr. David Wilber, director of Loyola's Cardiovascular Institute, is a co-author of the paper.
The trial is known as MADIT-RIT (Multicenter Automatic Defibrillator Implantation Trial - Reduce Inappropriate Therapy.) First author is Dr. Arthur J. Moss of the University of Rochester Medical Center.

An implantable cardioverter defibrillator (ICD) is about the size of a pocket watch, and is implanted below the collarbone. Wire leads connect to the heart. The device is designed to protect against tachyarrhythimas -- quivering, superfast heartbeats that prevent the heart from pumping blood effectively.

When the heart goes into a tachyarrhythimia, the ICD's pacemaker is activated. If the pacemaker fails to restore a normal rhythm, the ICD then delivers a powerful electric shock that jolts the heart back into a normal rhythm. But previous research, cited in the new paper, found that ICDs are inappropriately activated in between 8 percent and 40 percent of patients.

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