{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T18:14:33Z","timestamp":1774289673710,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,11,5]],"date-time":"2019-11-05T00:00:00Z","timestamp":1572912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004374","name":"Medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Contemporary implantable cardioverter\u2010defibrillator (ICD) programming involving delayed high\u2010rate detection and use of supraventricular tachycardia (SVT) discriminators has significantly reduced the rate of inappropriate shocks. The extent to which SVT algorithms alone reduce inappropriate therapies is poorly understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>PainFree SST enrolled 2770 patients with a single\u2010 or dual\u2010chamber ICD or cardiac resynchronization defibrillator. Patients were followed for 22\u2009\u00b1\u20099 months with SVT discriminators on in 96% of patients. Sustained ventricular tachyarrhythmias and SVT episodes were adjudicated by an independent physician committee. For this analysis, all episodes were subjected to postprocessing computer simulation with SVT discriminators off with and without delayed high\u2010rate detection criteria (ventricular fibrillation zone only, 30\/40 at 320\u2009ms). There were 3282 adjudicated SVT episodes of which 115 resulted in an ICD shock and 113 received only ATP (2\u2010year inappropriate shock and therapy rates of 3.1% and 4.1%). Therapy was appropriately withheld for the remaining 3054 SVT episodes. With both SVT discriminators and delayed high\u2010rate detection simulated off, the 2\u2010year inappropriate therapy rate would have been 22.9% (hazard ratio [HR]\u2009=\u20096.24; 95% confidence interval [CI]: 5.20\u20107.49). With SVT discriminators simulated off and delayed high\u2010rate detection simulated on in all patients, the 2\u2010year rate would have been 6.4% (HR\u2009=\u20091.63; CI: 1.44\u20101.85).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of SVT discriminators has a significant role in reducing the rate of inappropriate ICD therapy even in the setting of delayed high\u2010rate detection settings. Deactivating SVT discriminators would have resulted in an overall increase in the inappropriate ICD therapy rate by 63% and 524% with and without delayed high\u2010rate detection programming, respectively.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14250","type":"journal-article","created":{"date-parts":[[2019,10,24]],"date-time":"2019-10-24T04:50:56Z","timestamp":1571892656000},"page":"2877-2884","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["SVT discrimination algorithms significantly reduce the rate of inappropriate therapy in the setting of modern\u2010day delayed high\u2010rate detection programming"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8213-9115","authenticated-orcid":false,"given":"Alan","family":"Cheng","sequence":"first","affiliation":[{"name":"Medtronic, plc Mounds View Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Auricchio","sequence":"additional","affiliation":[{"name":"Fondazione Cardiocentro Ticino Lugano Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward J.","family":"Schloss","sequence":"additional","affiliation":[{"name":"The Christ Hospital\u2010Ohio Heart &amp; Vascular Cincinnati Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Kurita","sequence":"additional","affiliation":[{"name":"Kindai University School of Medicine Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence D.","family":"Sterns","sequence":"additional","affiliation":[{"name":"Royal Jubilee Hospital Victoria British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart","family":"Gerritse","sequence":"additional","affiliation":[{"name":"Medtronic Bakken Research Center Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark L.","family":"Brown","sequence":"additional","affiliation":[{"name":"Medtronic, plc Mounds View Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1430-4588","authenticated-orcid":false,"given":"Dedra H.","family":"Fagan","sequence":"additional","affiliation":[{"name":"Medtronic, plc Mounds View Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel R.","family":"Lexcen","sequence":"additional","affiliation":[{"name":"Medtronic, plc Mounds View Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth A.","family":"Ellenbogen","sequence":"additional","affiliation":[{"name":"Division of Cardiology Virginia Commonwealth University Richmond Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,11,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.11.018"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.05.011"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.4598"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211107"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000145610.64014.E4"},{"key":"e_1_2_7_7_1","unstructured":"Heart Rythm 2019 S1547\u20105271(19)30208\u20105 2019 HRS\/EHRA\/APHRS\/LAHRS focused update to 2015 expert consensus statement on optimal implantable cardioverter\u2010defibrillator programming and testing"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eur133"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.01.017"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw415"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2016.03.022"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-37804-8.00004-3"},{"key":"e_1_2_7_13_1","first-page":"615","volume-title":"Handbook of Survival Analysis","author":"Le\u2010Rademacher J","year":"2014"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.10.004"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2010.01918.x"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.14250","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.14250","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.14250","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T22:54:43Z","timestamp":1694040883000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.14250"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,5]]},"references-count":14,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1111\/jce.14250"],"URL":"https:\/\/doi.org\/10.1111\/jce.14250","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,5]]},"assertion":[{"value":"2019-02-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}