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Utility of routine follow-up defibrillator threshold testing in congenital heart disease and pediatric populations

Elizabeth A Stephenson1, Frank Cecchin, Edward P Walsh

  • 1Department of Cardiology, Children's Hospital, Boston, Boston, Massachusetts 02115, USA.

Journal of Cardiovascular Electrophysiology
|January 28, 2005
PubMed

Insights

Routine defibrillation threshold (DFT) testing for implantable cardioverter defibrillators (ICDs) in pediatric patients with congenital heart disease is valuable. Prompted DFT testing identified significant device abnormalities, highlighting its clinical importance in this unique population.

Area of Science:

  • Pediatric Cardiology
  • Biomedical Engineering
  • Electrophysiology

Background:

  • Routine defibrillation threshold (DFT) testing for implantable cardioverter defibrillators (ICDs) in adults is increasingly questioned.
  • Pediatric and congenital heart disease populations have a higher incidence of ICD lead failure.
  • The necessity of follow-up DFT testing in these unique patient groups requires investigation.

Purpose of the Study:

  • To investigate the utility and yield of follow-up defibrillation threshold (DFT) testing in pediatric patients with congenital heart disease.
  • To compare the outcomes of routine versus clinically prompted DFT testing in this population.

Main Methods:

  • Retrospective review of 155 implantable cardioverter defibrillator (ICD) recipients at a single center.
  • Analysis of patients who underwent one or more follow-up DFT tests, categorized into "routine" and "prompted" groups.
  • Evaluation of reprogramming or hardware changes resulting from DFT testing.

Main Results:

  • A total of 79 follow-up DFT procedures were analyzed (58 routine, 21 prompted).
  • Clinically significant changes requiring reprogramming or system revision were detected in 24% of all procedures.
  • Prompted testing showed a higher yield of abnormalities compared to routine testing.

Conclusions:

  • Follow-up defibrillation threshold (DFT) testing reveals a high rate of abnormalities in pediatric and congenital heart disease ICD recipients.
  • Clinically indicated (prompted) DFT testing is particularly valuable for assessing device function and ensuring patient safety.
  • These findings support the importance of targeted DFT testing in this high-risk population.
Abstract

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