Document Detail


Delayed defibrillation testing in patients implanted with biventricular ICD (CRT-D): a reliable and safe approach.
MedLine Citation:
PMID:  16403056     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Defibrillation testing (DT) at the end of the implantation of cardiac resynchronization pacemaker with a defibrillator (CRT-D) exposes heart failure (HF) patients to increased procedural risks. However, until now, delayed DT has not been assessed as a possible option in HF patients implanted with CRT-D. OBJECTIVE: Aim of the present study is to assess safety and feasibility of delayed DT in HF patients treated with CRT-D. MATERIAL AND METHODS: Two hundred and eleven consecutive patients (mean age: 65 years, mean NYHA class 3.0, mean EF: 29.3%) underwent CRT-D implantation from October 1999 to December 2004. In the first 17 patients, DT was performed at the end of CRT-D implantation. In the other 194 consecutive patients, DT was performed at 2 months after CRT-D implantation. Outcome of DT, as well as "acute" LV lead dislodgment rate were evaluated in the latter group of 194 patients undergoing a delayed DT. Also, ICD function was assessed through device telemetry analysis at 2 months. RESULTS: At delayed DT, first shock was effective in 187 of 194 patients (96%), ineffective VF interruption at maximum energy occurred only in one patient (0.5%), and acute LV lead dislodgment was 1%. No ICD therapy failure occurred in the 2-month untested period. CONCLUSION: DT performed 2 months after CRT-D implantation is safe and feasible; this is possibly related to the improvement of clinical conditions and hemodynamic status as well as greater lead stability 2 months after CRT-D.
Authors:
Maurizio Gasparini; Paola Galimberti; François Regoli; Carlo Ceriotti; Marika Bonadies
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  16     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2006-01-11     Completed Date:  2006-03-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1279-83     Citation Subset:  IM    
Affiliation:
Electrophysiology and Pacing Unit, Istituto Clinico Humanitas, Via Manzoni, Rozzano Milano, Italy. maurizio.gasparini@humanitas.it
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Cardiac Pacing, Artificial / adverse effects*
Defibrillators, Implantable / adverse effects*
Electric Countershock / instrumentation*
Feasibility Studies
Female
Heart Failure / therapy*
Heart Ventricles / physiopathology*
Humans
Male
Middle Aged
Safety
Time Factors
Comments/Corrections
Comment In:
J Cardiovasc Electrophysiol. 2005 Dec;16(12):1284-5   [PMID:  16403057 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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