This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Pacemakers/ Defibrillators  • Cardiovascular Intervention  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: Dr Wase raises the issue of inappropriately delivered ICD shocks. In reviewing all ICD shocks in our trial, those not potentially influenced by antiarrhythmic drugs (ie, due to lead fractures or dislodgements) were rare. Only 1 inappropriate shock was delivered for T-wave oversensing and the rest were delivered for supraventricular tachyarrhythmias (primarily atrial fibrillation). None of the patients in the OPTIC study had hypertrophic cardiomyopathy, a condition in which T-wave oversensing by the ICD is more likely to result in inappropriate shock delivery. We did not enroll patients in our study who presented with arrhythmic storms; these patients usually require antiarrhythmic therapy.

Dr Coceani raises the question of the antiarrhythmic potential of the various -blockers used in our trial. There is some evidence of specific antiarrhythmic efficacy of carvedilol in experimental studies.^1-2 However, no properly designed clinical trial has compared the effects of carvedilol vs those of metoprolol . . . [Full Text of this Article]

Stefan H. Hohnloser, MD
J. W. Goethe University
Frankfurt, Germany

Robin S. Roberts, MTech
McMaster University
Hamilton, Ontario

Eric Fain, MD
St Jude Medical
Sylmar, Calif

Stuart J. Connolly, MD
connostu@phri.ca
McMaster University
Hamilton, Ontario

RELATED ARTICLES

Antiarrhythmic Therapy for Prevention of Implantable Cardioverter Defibrillator Shocks
Abdul Wase
JAMA. 2006;296(10):1229.
EXTRACT | FULL TEXT  

Antiarrhythmic Therapy for Prevention of Implantable Cardioverter Defibrillator Shocks
Michele Coceani
JAMA. 2006;296(10):1229-1230.
EXTRACT | FULL TEXT  

Comparison of -Blockers, Amiodarone Plus -Blockers, or Sotalol for Prevention of Shocks From Implantable Cardioverter Defibrillators: The OPTIC Study: A Randomized Trial
Stuart J. Connolly, Paul Dorian, Robin S. Roberts, Michael Gent, Steven Bailin, Eric S. Fain, Kevin Thorpe, Jean Champagne, Mario Talajic, Benoit Coutu, Gerian C. Gronefeld, Stefan H. Hohnloser, and for the Optimal Pharmacological Therapy in Cardioverter Defibrillator Patients (OPTIC) Investigators
JAMA. 2006;295(2):165-171.
ABSTRACT | FULL TEXT