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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article presents results of the secondary prevention substudy of the Study to Evaluate System Safety and Clinical Performance of the Protecta Implantable Cardioverter Defibrillator (ICD) Plus Cardiac Resynchronization Therapy Defibrillator (CRT-D) trial [PainFree SST; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00982397\u0026amp;atom=%2Fspmdc%2F14%2F9%2F22.1.atom\u0022\u003ENCT00982397\u003C\/a\u003E]. This prospective, randomized, multicenter study demonstrated that defibrillators programmed with longer detection intervals are safe for secondary prevention in patients with ICDs.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ELaurence D. Sterns, MD, Royal Jubilee Hospital, Victoria, British Columbia, Canada, presented results of the secondary prevention substudy of the Study to Evaluate System Safety and Clinical Performance of the Protecta Implantable Cardioverter Defibrillator (ICD) Plus Cardiac Resynchronization Therapy Defibrillator (CRT-D) trial [PainFree SST; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00982397\u0026amp;atom=%2Fspmdc%2F14%2F9%2F22.1.atom\u0022\u003ENCT00982397\u003C\/a\u003E]. This prospective, randomized, multicenter study demonstrated that defibrillators programmed with longer detection intervals are safe for secondary prevention in patients with ICDs.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EAlthough previous studies have shown that extended ICD detection times for ventricular tachycardia or ventricular fibrillation (VF) reduce inappropriate therapies and mortality in primary prevention patients [Gasparini M et al. \u003Cem\u003EJAMA\u003C\/em\u003E 2013; Moss AJ et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2012; Wilkoff BL et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E 2008], the effect of prolonged ICD detection in secondary prevention patients who have already experienced episodes of sudden cardiac arrest and are at increased risk for a deadly irregular heart rhythm had not been evaluated.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EProf. Sterns and colleagues conducted the PainFree SST trial to investigate the safety of prolonged detection for ventricular tachycardia or VF in secondary prevention patients. To be included in the study, patients were required to have secondary prevention indications for ICD.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EPatients with mechanical tricuspid valves, those enrolled in concurrent drug or medical device studies, and those who were unwilling to provide written informed consent to participate in the study or who anticipated being unable to complete it were excluded from the trial.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe PainFree SST trial enrolled a total of 2790 patients receiving ICDs programmed with technology that enables the devices to discern whether an abnormal heart rhythm is life threatening. Of these participants, 705 were included in this substudy and were randomly assigned 1:1 to either standard interval detection (VF number of intervals to detect, 18 of 24; n=353) or extended interval detection (VF number of intervals to detect, 30 of 40; n=352) of ventricular tachycardia or VF \u2265188 beats\/minute.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThe primary end point was freedom from arrhythmic syncope at 1 year. Secondary end points included time to first arrhythmic and all-cause syncope, appropriate therapy or inappropriate shock, and mortality.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EAt baseline, 35% of patients had atrial arrhythmias, and 33% had histories of syncope. At 1 year, 7 patients in the standard group and 11 in the prolonged group had arrhythmic syncope. The arrhythmic syncope-free rate was similar between the standard and prolonged groups (98.0% vs 96.9%; p=0.012 for noninferiority). There was no statistically significant increase in the time to first arrhythmic syncope (HR 1.52; 95% CI 0.66\u20133.52; p=0.32), incidence of all-cause syncope (HR, 1.17; 95% CI, 0.59\u20132.32; p=0.66), appropriate VF zone therapies (HR, 0.98; 95% CI, 0.67\u20131.43; p=0.91), time to first appropriate shock (HR, 1.04; 95% CI, 0.70\u20131.53; p=0.85), or incidence of inappropriate shocks (1.0% vs 1.3%, p=0.74). However, in the prolonged group, the VF therapy rate (1.5 vs 0.4, p=0.0001), VF shock rate (0.9 vs 0.27, p=0.0026), and VF antitachycardia pacing rate (0.57 vs 0.16; p=0.0019) were significantly lower.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EThe results of this substudy demonstrated that extended interval detections did not result in statistically increased risk for syncope in secondary prevention patients. Prof. Sterns concluded that the prolonged detection programming strategy may be considered as a strategy to reduce inappropriate shocks in patients with ICDs.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/9\/22.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzp6mp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}