| Canadian Registry of ICD Implant Testing procedures (CREDIT): current practice, risks, and costs of intraoperative defibrillation testing. | |
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MedLine Citation:
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PMID: 19804544 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: There is uncertainty about the proper role of defibrillation testing (DT) at the time of implantable cardioverter defibrillator (ICD) insertion. METHODS: A prospective registry was conducted at 13 sites in Canada between January 2006 and October 2007. OBJECTIVES: To document the details of DT, the reasons for not conducting DT, and the costs and complications associated with DT. RESULTS: DT was conducted at implantation in 230 of 361 patients (64%). DT was more likely to be conducted for new implants compared with impulse generator replacements (71% vs 32%, P = 0.0001), but was similar for primary and secondary prevention indications (64% vs 63%, P = NS). Among patients not having DT, the reason(s) given were: considered unnecessary (44%); considered unsafe, mainly due to persistent atrial fibrillation (37%); lack of an anesthetist (20%); and, patient or physician preference (6%). When performed, DT consisted of a single successful shock > or = 10J below maximum device output in 65% of cases. A 10J safety-margin was met by 97% of patients, requiring system modification in 2.3%. Major perioperative complications occurred in 4.4% of patients having DT versus 6.6% of patients not having DT (P = NS). ICD insertion was $844 more expensive for patients having DT (P = 0.16), largely due to increased costs ($28,017 vs $24,545) among patients having impulse generator replacement (P = 0.02). CONCLUSIONS: DT was not performed in a third of ICD implants, usually due to a perceived lack of need or relative contraindication. |
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Authors:
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Jeff S Healey; Paul Dorian; L Brent Mitchell; Mario Talajic; Francois Philippon; Chris Simpson; Raymond Yee; Carlos A Morillo; Andre Lamy; Magdy Basta; David H Birnie; Xiaoyin Wang; Girish M Nair; Eugene Crystal; Charles R Kerr; Stuart J Connolly; |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-10-05 |
Journal Detail:
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Title: Journal of cardiovascular electrophysiology Volume: 21 ISSN: 1540-8167 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-05-21 Completed Date: 2010-09-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 177-82 Citation Subset: IM |
Affiliation:
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The Population Health Research Institute, McMaster University, Hamilton, Canada. healeyj@hhsc.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Canada / epidemiology Defibrillators, Implantable / economics*, statistics & numerical data Equipment Failure Analysis / economics*, statistics & numerical data Health Care Costs / statistics & numerical data Heart Failure / economics*, epidemiology, prevention & control* Humans Intraoperative Care / utilization* Middle Aged Physician's Practice Patterns / economics*, statistics & numerical data Prevalence Registries / statistics & numerical data* Risk Assessment Risk Factors |
| Comments/Corrections | |
Comment In:
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J Cardiovasc Electrophysiol. 2010 Feb;21(2):183-5
[PMID:
19804540
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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