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Related Experiment Videos

Defibrillation efficacy testing: long-term follow-up and mortality.

Dominic A M J Theuns1, Tamas Szili-Torok, Luc J Jordaens

  • 1Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands. d.theuns@erasmusmc.nl

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
|October 12, 2005
PubMed
Summary

Defibrillation threshold testing after implantation is crucial. A high lowest effective defibrillation (LED) level at implantation, especially without improvement, predicts higher mortality in certain patients.

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Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • Defibrillation threshold testing is evolving with improved device efficacy.
  • Assessing the lowest effective defibrillation (LED) level at implantation and before discharge is key.
  • Understanding LED's relation to patient outcomes is vital.

Purpose of the Study:

  • To evaluate the lowest effective defibrillation (LED) level at implantation and before hospital discharge.
  • To determine the relationship between LED and patient outcomes.
  • To identify predictors of mortality in patients receiving defibrillation devices.

Main Methods:

  • Studied 127 patients with biphasic shock and active can devices.
  • Assessed intraoperative and predischarge LED levels.

Related Experiment Videos

  • Defined improvement as a decrease in LED by >= 3 J; analyzed a subgroup with >= 3 VF inductions.

    • Main Results:

    • LED was significantly higher at implantation than predischarge (P < 0.001).
    • 58% of patients showed improvement in LED.
    • For patients with >= 3 VF inductions, implantation LED > 9 J without improvement predicted mortality.

    Conclusions:

    • Repeated defibrillation testing before discharge can identify patients requiring high energy.
    • A high implantation LED, particularly without improvement, is linked to increased long-term mortality.
    • This highlights the importance of comprehensive defibrillation testing for risk stratification.