Document Detail


Role of defibrillation threshold testing in the contemporary defibrillator patient population.
MedLine Citation:
PMID:  23210803     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Defibrillation threshold (DFT) testing has been performed to prove functionality of the implantable cardioverter defibrillator (ICD). Over the past years it has become increasingly controversial because of possible morbidity and mortality. The goal of this study was to determine unsuccessful shock testing and report strategies used to overcome these problems.
METHODS AND RESULTS: A total of 314 patients with a de novo implantation of an ICD and 127 patients receiving a generator exchange were identified retrospectively. All patients underwent defibrillation threshold testing after induction of VF using a low-energy T-wave shock during the intervention, 2 shock tests after de novo implantations, 1 after generator change. A safety margin of 10 J or more was requested. Seven (2.3%) patients in the de novo group and 2 patients (1.4%) in the generator exchange group could not be defibrillated using the standard approach. All of those patients had either chronic amiodarone therapy, secondary prevention or a cardiac resynchronization therapy device (CRT). In univariate analysis, amiodarone therapy, dilated cardiomyopathy, and lower ejection fraction were predictors of failure.
CONCLUSION: Our study's results as well as a review of the current literature favor shock testing, especially in patients with specific risk factors as mentioned above.
Authors:
Annina S Vischer; Christian Sticherling; Michael S Kühne; Stefan Osswald; Beat A Schaer
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Publication Detail:
Type:  Journal Article     Date:  2012-12-04
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  24     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-04     Completed Date:  2013-09-30     Revised Date:  2014-01-20    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  437-41     Citation Subset:  IM    
Copyright Information:
© 2012 Wiley Periodicals, Inc.
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MeSH Terms
Descriptor/Qualifier:
Aged
Amiodarone / therapeutic use
Anti-Arrhythmia Agents / therapeutic use
Cardiac Resynchronization Therapy Devices
Cardiomyopathy, Dilated / complications
Defibrillators, Implantable*
Device Removal
Electric Countershock / instrumentation*
Electrophysiologic Techniques, Cardiac*
Equipment Safety
Female
Heart Failure / etiology,  physiopathology,  therapy*
Humans
Male
Materials Testing
Middle Aged
Predictive Value of Tests
Prosthesis Design
Prosthesis Failure
Retrospective Studies
Risk Factors
Stroke Volume
Treatment Outcome
Ventricular Fibrillation / etiology,  physiopathology,  prevention & control*
Ventricular Function, Left
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; N3RQ532IUT/Amiodarone
Comments/Corrections
Comment In:
J Cardiovasc Electrophysiol. 2013 Dec;24(12):E18   [PMID:  24028634 ]
J Cardiovasc Electrophysiol. 2013 Dec;24(12):E19   [PMID:  24020827 ]

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