Document Detail

Defibrillation efficacy testing: long-term follow-up and mortality.
MedLine Citation:
PMID:  16216750     Owner:  NLM     Status:  MEDLINE    
AIMS: Extensive defibrillation threshold testing is no longer necessary to perform as devices have become more effective. We assessed the lowest effective defibrillation (LED) level at implantation and before hospital discharge and related this to outcome. METHODS AND RESULTS: One hundred and twenty-seven consecutive patients with biphasic shock and active can devices were studied at intraoperative and predischarge testing. A subgroup of 67 patients had > or = 3 VF inductions at implant. Improvement was defined when LED decreased by > or = 3 J. The LED was significantly higher at implantation compared with predischarge (P < 0.001). Improvement was seen in 73/127 patients (58%). In the group with > or = 3 VF inductions, an implantation LED > 9 J was related to a lower LVEF (P < 0.01); 34/67 patients (51%) had improvement in LED. During follow-up, 18/127 patients died, four received heart transplantation. No different outcome was observed in patients with and without improvement. However, for those with > or = 3 VF inductions, an independent predictor of mortality was implantation LED > 9 J without improvement on the second test. Safety margin < 10 J was not related to mortality. CONCLUSION: Repeated defibrillation efficacy testing before hospital discharge may confirm that a relatively high defibrillation energy is required. This is related to a higher mortality in long-term follow-up.
Dominic A M J Theuns; Tamas Szili-Torok; Luc J Jordaens
Publication Detail:
Type:  Journal Article     Date:  2005-07-18
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  7     ISSN:  1099-5129     ISO Abbreviation:  Europace     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-11     Completed Date:  2006-02-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  509-15     Citation Subset:  IM    
Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
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MeSH Terms
Aged, 80 and over
Arrhythmias, Cardiac / physiopathology,  therapy
Cause of Death
Death, Sudden, Cardiac
Defibrillators, Implantable*
Electrophysiologic Techniques, Cardiac*
Middle Aged
Ventricular Fibrillation / physiopathology

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