Observational studyJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2019
Single-brand dual-chamber discriminators to prevent inappropriate shocks in patients implanted with prophylactic implantable cardioverter defibrillators: a propensity-weighted comparison of single- and dual-chamber devices.
Observational study in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- ACC/AHA/ASE/HFSA/HRS/SCAI/SCCT/SCMR 2025 Appropriate Use Criteria for Implantable Cardioverter-Defibrillators, Cardiac Resynchronization Therapy, and Pacing.Journal of the American College of Cardiology · 2025Guideline
- Comparison of Single-Coil Versus Dual-Coil Implantable Cardioverter Defibrillator Devices: A Systematic Review and Meta-Analysis of Efficacy and Extraction-Related Outcomes.Clinical cardiology · 2025Pooled it
- Predictors of Atrial High-Rate Episodes and Inappropriate Device Therapy in Implantable Cardioverter Defibrillators.Pacing and clinical electrophysiology : PACE · 2026Article
- Next-generation ICDs: Individualised Selection for Improved Cardiac Outcomes.Arrhythmia & electrophysiology review · 2026Review
- Implantable Defibrillators: Which Is the Best Device for Each Patient?Journal of cardiovascular electrophysiology · 2025Review
- Head-to-Head Comparison of Single- Versus Dual-Chamber ICD Discriminators for Tachyarrhythmia Detection: A Single-Manufacturer, Remote Monitoring-Based Bicentric Study.Journal of clinical medicine · 2025Article
- Arrhythmia Detection in Atrioventricular, Single-Lead, Floating Atrial Dipole ICD Systems Compared with Conventional Single- and Dual-Chamber Defibrillators.Journal of cardiovascular development and disease · 2024Article
- Successful Identification of and Discrimination Between Atrial and Ventricular Arrhythmia with the Aid of Pacing and Defibrillator Devices.Arrhythmia & electrophysiology review · 2021Review
- Long-Term Outcomes Among a Nationwide Cohort of Patients Using an Implantable Cardioverter-Defibrillator: UMBRELLA Study Final Results.Journal of the American Heart Association · 2021Observational
- Over- and undersensing-pitfalls of arrhythmia detection with implantable devices and wearables.Herzschrittmachertherapie & Elektrophysiologie · 2020Review
Corrections and comments
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Authors and funding
12 authors at 10 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeComparisons of the efficacy of dual- vs. single-chamber implantable cardioverter defibrillators (ICDs) in preventing inappropriate shocks have had contradictory results. We investigated whether dual-chamber devices have a lower risk of inappropriate shocks and the specific role of supraventricular tachycardia (SVT) discriminators.
methodsAll heart failure (HF) patients without an indication for pacing and implanted with a prophylactic ICD were recruited from the nationwide multicenter UMBRELLA registry. Arrhythmic events were collected by remote monitoring and reviewed by a committee of experts.
resultsAmong 782 patients, single-chamber ICDs were implanted in 537 (68.7%) and dual-chamber devices in 245 (31.3%). During a mean follow-up of 52.2 ± 24.5 months, 109 inappropriate shocks were delivered in 49 patients (6.2%). In the propensity-score-matched analysis, dual-chamber ICDs were related to lower rates of inappropriate shocks as compared to single-chamber devices (0.9% vs. 11.8%, p = < 0.001, log-rank test). In multivariable Cox proportional analysis, independent predictors of inappropriate shock were history of atrial fibrillation (hazard ratio (HR) = 2.78, CI 1.37-5.64, p = 0.004), chronic kidney disease (HR = 6.15, CI 2.82-13.53, p < 0.001), and non-ischemic cardiomyopathy (HR = 2.84, CI 1.54-5.23, p = 0.001). Among ICD settings, PR logic was the only discriminator independently related to a reduced risk of inappropriate shocks (HR = 0.18, CI 0.06-0.48, p = 0.001), along with an SVT limit enabled over 200 bpm (HR = 0.24, CI 0.11-0.51, p < 0.001).
conclusionsIn this nationwide cohort of primary prevention ICD-only patients, dual-chamber devices were related to lower risk of inappropriate shocks compared to single-chamber ICDs. Besides, PR logic and SVT limit > 200 bpm emerged as protective factors.
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