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Related Experiment Video

Updated: Jul 7, 2026

Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine
05:36

Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine

Published on: January 30, 2020

Is defibrillation testing still necessary? A decision analysis and Markov model.

Lorne J Gula1, David Massel, Andrew D Krahn

  • 1Division of Cardiology, University of Western Ontario, London, Ontario, Canada. lgula@uwo.ca

Journal of Cardiovascular Electrophysiology
|February 27, 2008
PubMed
Summary

Defibrillation threshold (DFT) testing for implantable cardioverter-defibrillators (ICDs) shows minimal impact on 5-year survival. Routine DFT testing offers a small, non-significant survival advantage in ICD patients.

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A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique
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Published on: April 26, 2015

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Last Updated: Jul 7, 2026

Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine
05:36

Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine

Published on: January 30, 2020

A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique
09:47

A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique

Published on: April 26, 2015

Area of Science:

  • Cardiology
  • Medical Devices
  • Clinical Outcomes

Background:

  • Defibrillation threshold (DFT) testing is standard during implantable cardioverter-defibrillator (ICD) implantation.
  • It assesses sensing and ventricular fibrillation termination with a safety margin.
  • Limited data exist on DFT testing's impact on patient outcomes.

Purpose of the Study:

  • To evaluate the effect of DFT testing on survival in patients with ICDs.
  • To compare survival outcomes between routine DFT testing and no DFT testing strategies.

Main Methods:

  • Decision analysis and Monte Carlo simulation were employed.
  • A hypothetical cohort of ICD patients was modeled.
  • Survival was assessed under two strategies: routine DFT testing vs. no DFT testing.

Main Results:

  • Five-year survival rates were similar: 59.72% with DFT testing and 59.36% without.
  • Results were robust to variations in arrhythmia risk and safety margin estimates.
  • Monte Carlo simulations indicated a small, non-significant survival benefit with routine DFT testing.

Conclusions:

  • The impact of DFT testing on 5-year survival in ICD patients is minimal.
  • Survival may be slightly higher with DFT testing if annual lethal arrhythmia risk or narrow safety margin risk is ≥5%.
  • A prospective randomized trial is recommended to further investigate DFT testing in modern ICDs.