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Related Experiment Videos

[Is DFT testing still mandatory?].

Jörg Neuzner1

  • 1Medizinische Klinik II, Klinikum Kassel. neuzner@klinikum-kassel.de

Herz
|December 8, 2005
PubMed
Summary
This summary is machine-generated.

Intraoperative defibrillation testing for implantable cardioverter defibrillators (ICDs) remains crucial. Abandoning this assessment may compromise patient safety, as its benefits outweigh potential time and cost savings.

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Sedation strategies for defibrillation threshold testing: safety outcomes with anaesthesiologist compared to proceduralist-directed sedation: an analysis from the SIMPLE study.

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·2018

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Devices

Context:

  • Implantable cardioverter defibrillator (ICD) therapy relies on automatic detection and termination of ventricular fibrillation.
  • Advancements in generator and lead technology have improved defibrillation efficacy.
  • Current pectoral biphasic devices offer high defibrillation success rates, with over 90% of patients meeting implantation criteria without intraoperative modifications.

Purpose:

  • To evaluate whether the high success rates of modern implantable cardioverter defibrillator (ICD) systems negate the need for intraoperative defibrillation efficacy testing.
  • To weigh the arguments for and against abandoning intraoperative device testing, considering perioperative complications, time/cost savings, patient prognosis, and accessibility.

Summary:

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  • While modern ICDs show high efficacy, abandoning intraoperative testing could risk inadequate defibrillation safety in up to 9% of patients.
  • The purported benefits of abandoning testing, such as reduced complications and costs, are not definitively proven, and potential negative impacts on patient outcomes remain.
  • Limited intraoperative testing protocols are safe and effective, suggesting that intraoperative assessment should remain an integral part of ICD implantation.

    • Impact:

    • Maintaining intraoperative defibrillation testing ensures patient safety and optimal device function.
    • This practice supports the long-term efficacy of ICD therapy, particularly for patients who might have borderline defibrillation efficacy.
    • Continued intraoperative assessment is vital for establishing robust safety standards in ICD implantation procedures.