Efficacy and safety of implantable cardioverter defibrillator avoiding routine defibrillation threshold testing.
- Author:
Qiming LIU
1
;
Shenghua ZHOU
;
Shushan QI
;
Gaofeng ZENG
;
Xiaofeng MA
;
He HUANG
Author Information
1. Department of Cardiology, Central South University, Changsha 410011, China. qimingliu@yahoo.com.cn
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Aged;
Arrhythmias, Cardiac;
therapy;
Defibrillators, Implantable;
adverse effects;
standards;
Electric Countershock;
adverse effects;
standards;
Equipment Safety;
Female;
Follow-Up Studies;
Humans;
Male;
Middle Aged;
Sensory Thresholds;
Unnecessary Procedures;
Ventricular Fibrillation;
etiology;
prevention & control;
Young Adult
- From:
Journal of Central South University(Medical Sciences)
2009;34(11):1132-1135
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To evaluate the efficacy and safety of implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy-defibrillators (CRT-D) avoiding defibrillation threshold (DFT) testing when treating ventricular tachycardia (VT) or ventricular fibrillation (VF).
METHODS:We analyzed a continuous database of the 21 patients who had avoided DFT during ICD implantation from Oct. 1999 to Aug. 2008. Follow-up data were completed and analyzed in the 21 patients with ICD implantation.
RESULTS:ICDs were implanted successfully in 17 patients with VT or VF, and CRT-D were implanted successfully in 4 myocardiopathy patients with severe heart failure who avoided DFT during ICD or CRT-D implantation. Eight patients accepted DFT 1 week later, VT or VF was not induced in 3 patients (37.5%). During the mean follow-up of 1 approximately 7 (4.2+/-1.9) years, malignant ventricular arrythmia was recorded in 16 patients. Among them, 89 episodes were successfully terminated by defbrillation (100%), 120 VT events were terminated by the first run of antitachycardia pacing (51.1%) and 22 by low energy cardioversion (59.2%). All patients took antiarrhycardia drugs after ICD or CRT-D implantation. No patient died from malignant ventricular arrythmia during the follow-up.
CONCLUSION:No application of routine DFT may avoid complications associated with DFT during ICD or CRT-D implantation. ICD or CRT-D implantation may effectively treat fatal ventricular tachyarrhythmias and prevent sudden cardiac death.
