ICD programming

BackgroundAppropriate ICD programming is the key to prevent inappropriate shock delivery, that is closely associated to a negative patients' outcome.MethodsReview of the literature on ICD therapy to generate ICD programmings that can be applied to the broad population of ICD and CRT-D carriers.ResultsArrhythmia detection should occur with a detection time ranging 9″–12″ in the VF zone, and 15″–60″ in the VT zone. Discriminator should be applied at least up to 200 bpm. ATP therapy is applied to all VTs up to 250 bpm, with a success rate of 70%. Inappropriate shocks should occur in <3.6% of patients.ConclusionTailored ICD programming can be achieved following evidence from large ICD trials. Pre-defined settings that are saved on the programmer and that can be uploaded at device implantation help to ensure optimal programming and to avoid random errors.