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The well-established survival benefits of implantable cardioverter-defibrillators (ICDs) can be tempered by the delivery of sometimes inappropriate shocks. To evaluate programming strategies for mitigating such shocks, researchers conducted a trial, funded by an ICD manufacturer, in which 1500 patients with a primary indication for an ICD were randomized to one of three programming configurations:
High-rate therapy: a 2.5-second delay before therapy initiation at a heart rate of ≥200 bpm
Delayed therapy: a 60-second delay at 170–199 bpm, a 12-second delay at 200–249 bpm, and a 2.5-second delay at ≥250 bpm
Conventional therapy: a 2.5-second delay at 170–199 bpm and a 1-second delay at ≥200 bpm
During a mean follow-up of 1.4 years, programming to…