P2873Novel ICD therapy reduction programming in primary and secondary prevention: reduced mortality and ICD-therapies in a real-life cohort

Abstract Background Implantable cardioverter defibrillator therapy (ICD), with or without combined cardiac resynchronization therapy, has been demonstrated to reduce mortality and morbidity in patients with heart failure. Nevertheless, ICD therapies are associated with increased mortality and morbidity. It was shown that ICD therapy reduction was associated with reduced event-rates. Aims It was our goal to examine a novel therapy reduction ICD programming in a real-life-cohort that also includes a notable proportion of patients with secondary prevention ICD indication. Methods Our study, based on a real-life register, contained 1013 patients. 609 patients (60%) received ICDs or CRT-Ds for secondary prevention indication. Devices implanted before May 2014 were programmed according to conventional ICD programming (CP), devices implanted since May 2014 have been programmed with a novel programming (NP) (high rate cut-off, longer detection intervals, 4 to 6 ATPs in VT-Zone). The following endpoints were analyzed for time to first event: mortality (247), appropriate therapies (248), appropriate ATPs (172), appropriate shocks (150), inappropriate therapies (102), inappropriate ATPs (49) and shocks (150). Results Middle follow-up time was 25.6 months (IQR 14.0–36.0 months) and cumulative patient years (PY) were 2165.3. According to Kaplan-Meier-analysis, there was a significant reduction in mortality-rate due NP compared to CP (19.2% vs. 30.2%, p=0.001) in the whole study population, as well as in patient subgroups with primary and secondary prevention (each p