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A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique
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High defibrillation threshold: the science, signs and solutions.

Sony Jacob1, Victorio Pidlaoan, Jaspreet Singh

  • 1Division of Cardiology / Electrophysiology,Department of Internal medicine, Wayne State University, Detroit, Michigan, USA. jacobsony@yahoo.com

Indian Pacing and Electrophysiology Journal
|January 20, 2010
PubMed
Summary

High defibrillation threshold (DFT) in implantable cardioverter defibrillator (ICD) patients requires understanding electrophysiology and molecular mechanisms. Addressing high DFT involves risk assessment, identifying contributing factors, and implementing a step-wise algorithm for device adjustment.

Keywords:
DFTDefibrillation threshold testingimplantable cardioverter defibrillator

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16:40

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

Area of Science:

  • Cardiovascular Electrophysiology
  • Medical Device Technology

Background:

  • Defibrillation threshold (DFT) testing is crucial for implantable cardioverter defibrillator (ICD) implantation.
  • Increasing ICD use leads to more frequent encounters with high DFT.
  • Understanding high DFT requires knowledge of defibrillation science, electrophysiological concepts, and molecular mechanisms.

Purpose of the Study:

  • To provide an in-depth understanding of the science, signs, and solutions for high DFT.
  • To review factors implicated in the causation of high DFT.
  • To outline a step-wise algorithm for managing high DFT during ICD implantation.

Main Methods:

  • Review of factors contributing to high DFT, including medical history, pharmacotherapy, lab data, and cardiac imaging.
  • Analysis of drugs, procedural changes, and ICD lead systems in predicting DFT.
  • Presentation of a step-wise management algorithm for high DFT.

Main Results:

  • Numerous factors contribute to high DFT, necessitating comprehensive pre-procedural risk assessment.
  • Specific drugs, procedural modifications, and ICD lead characteristics influence DFT during implantation.
  • A structured approach is recommended when encountering unacceptably high DFT.

Conclusions:

  • Managing high DFT requires a thorough understanding of underlying mechanisms and contributing factors.
  • A systematic approach, starting with ruling out complications and addressing reversible derangements, is essential.
  • Electrophysiologists have various device adjustment and system modification options when high DFT persists.