In the current ICD, progressive course of therapy ensures that...

In the current ICD, progressive course of therapy ensures that...

• A. Shock therapy within an episode will always be delivered more aggressively.
• B. ATP is delivered first
• C. Shocks are suppressed if the patient wakes up
• D. Therapy is slowed down after multiple episodes

Answer: (A)

Progressive therapy in an ICD means the device escalates its interventions within a single arrhythmia episode. When VT or VF is detected, it first tries a less invasive approach (anti-tachycardia pacing) and, if needed, moves to shocks. If the episode persists, the device delivers more aggressive therapies—higher-energy shocks or additional ATP sequences—on subsequent cycles until the rhythm is terminated. This stepwise escalation explains why shocks within an episode are delivered more aggressively as therapy progresses. The other descriptions don’t capture this within-episode escalation: ATP is used early, but the defining idea is the increasing aggressiveness of therapy if the episode continues; shocks aren’t simply suppressed because the patient is awake, and therapy isn’t typically slowed after multiple episodes.

Progressive therapy in an ICD means the device escalates its interventions within a single arrhythmia episode. When VT or VF is detected, it first tries a less invasive approach (anti-tachycardia pacing) and, if needed, moves to shocks. If the episode persists, the device delivers more aggressive therapies—higher-energy shocks or additional ATP sequences—on subsequent cycles until the rhythm is terminated. This stepwise escalation explains why shocks within an episode are delivered more aggressively as therapy progresses. The other descriptions don’t capture this within-episode escalation: ATP is used early, but the defining idea is the increasing aggressiveness of therapy if the episode continues; shocks aren’t simply suppressed because the patient is awake, and therapy isn’t typically slowed after multiple episodes.