Optimal Strategies to Reduce Inappropriate Implantable Cardioverter-defibrillator Shocks

Since the widespread implementation of implantable cardioverter-defibrillators (ICDs), their effectiveness in various situations has become well-established. However, despite many advances in both the technology and its utilization, inappropriate therapy remains a risk. Here, we review ICD shocks, their effect on outcomes, and current methods to reduce inappropriate therapy, finding overall that inappropriate ICD shocks are common and associated with adverse outcomes. However, strategies do exist to minimize inappropriate shock rates including device selection and programming, medication, catheter ablation, and remote monitoring. Overall, ICDs are useful in reducing the risk of sudden cardiac death, but many patients with an ICD will receive an inappropriate shock. Understanding strategies to prevent inappropriate shocks is crucial to improving the care of patients with ICDs.