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JAMA: Journal of the American Medical Association

Some data suggest that programming implantable cardioverter-defibrillators (ICDs) to use a greater number of intervals to detect ventricular tachyarrhythmias is associated with a reduction in unnecessary ICD therapies. In a multicenter trial that enrolled 1902 patients undergoing their first ICD implant for primary or secondary prevention, Gasparini and colleagues randomly assigned patients to receive an ICD programmed for either long-interval detection (using 30 of 40 intervals) or standard-interval detection (using 18 of 24 intervals) to detect ventricular arrhythmias. The authors report that use of a long-detection interval resulted in a lower rate of the combined trial end point of antitachycardia pacing, shocks, and inappropriate shocks. In an editorial, Raitt discusses optimization of ICD programming to reduce shocks and minimize adverse consequences.