Positive results comparing programming of S-ICD and CRT-D defibrillators (Boston Scientific) in patients at risk of Cardiac Arrest

New results from the MADIT-RIT clinical trial demonstrated improved programming of Boston Scientific dual-chamber implantable cardioverter defibrillator (S-ICD) or cardiac resynchronization therapy defibrillator (CRT-D) heart devices can reduce inappropriate therapy and risk of death. MADIT-RIT is a prospective randomized three-arm trial comparing conventional programming with two alternative settings: a high-rate therapy arm and a duration-delay arm. It evaluated 1,500 primary prevention patients with an ICD or CRT-D at 98 centers in 15 countries.

When compared to conventional programming, significant reduction of inappropriate therapy was seen in both the high-rate and duration-delay therapy arms [79 and 76 per cent, respectively (p<0.001 in both arms)]. in the high-rate therapy arm, there was a significant 55 percent reduction of the risk of death (p="0.01)" compared to conventional programming. while not statistically significant, the risk of mortality was reduced in the duration-delay therapy arm by 44 percent (p="0.06)." the full madit-rit results were published in the new england journal of medicine: "reduction in inappropriate therapy and mortality through icd programming" arthur j. moss et al. nejm, november 6, 2012 doi: 10.1056 nejmoa1211107>