Medical societies release consensus statement on ICD programming and testing

Major electrophysiology and cardiology societies released an expert consensus statement on Nov. 19 on optimal implantable cardioverter-defibrillator (ICD) programming and testing.

The authors mentioned that programming and surgical decisions play a major role in ICD therapy. They limited the consensus statement to the following four areas where there was sufficient data and agreement: bradycardia mode and rate, tachycardia detection, tachycardia therapy and the intraprocedural testing of defibrillation efficacy.

The Heart Rhythm Society, European Heart Rhythm Association, Asia Pacific Heart Rhythm Society and the Socieded Latinoamericana de Estimulacion Cardiaca y Electrofisiologia developed the consensus statement. The American College of Cardiology and American Heart Association endorsed the statement.

The 35 writing committee members approved 32 recommendations with an average recommendation of 96 percent. The consensus statement includes information on each ICD manufacturer and model.

“Making strategic programming choices when implementing ICD therapy is quite complex,” Cleveland Clinic chair Bruce Wilkoff, MD, FHRS, CCDS, said in a news release. “This new expert consensus statement provides a much needed single set of recommendations that clinicians from around the world can consult.”

The appropriate use of ICDs received national attention in late October when 457 hospitals reached settlements worth a total of $250 million with the Department of Justice (DOJ). The settlements related to allegations that physicians improperly implanted ICDs in Medicare patients.

The DOJ’s investigation into other hospitals and health systems is ongoing.

When putting together the consensus statement, writing committee members said they planned on publishing more recommendations when further information becomes available.

“This document is a beginning; necessary because there is now sufficient data to support recommendations that improve the safety, morbidity and mortality of patients with ICDs,” they wrote.