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Long-term internal cardiac defibrillation threshold stability.

J N Wetherbee1, P D Chapman, P J Troup

  • 1Department of Medicine, Medical College of Wisconsin, Milwaukee.

Pacing and Clinical Electrophysiology : PACE
|March 1, 1989
PubMed
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The energy needed for automatic implantable cardioverter-defibrillators (ICDs) to stop dangerous heart rhythms remains stable over time. This stability ensures continued effectiveness of ICDs for patients requiring life-saving therapy.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Device Technology

Background:

  • Automatic implantable cardioverter-defibrillators (ICDs) are crucial for managing life-threatening ventricular arrhythmias.
  • Intraoperative defibrillation trials confirm initial device effectiveness.
  • Long-term stability of defibrillation energy requirements for ICDs is not well-established.

Purpose of the Study:

  • To assess the stability of defibrillation energy requirements for ICDs over time.
  • To determine if initial defibrillation effectiveness is maintained until generator replacement.
  • To investigate factors influencing defibrillation threshold stability.

Main Methods:

  • A cohort of 56 patients undergoing ICD lead implantation was studied.

Related Experiment Videos

  • Defibrillation energy requirements were measured at initial implantation and generator replacement.
  • Transmyocardial impedance, cardiac medications, concomitant surgery, and clinical shocks were analyzed for their impact.

    • Main Results:

    • The mean time between generator replacement was 17.6 months.
    • Defibrillation thresholds remained stable, with no significant difference between initial and follow-up measurements (11.9 J vs. 12.7 J).
    • No correlation was found between transmyocardial impedance and defibrillation threshold; cardiac medications, surgery, or prior shocks did not affect the threshold.

    Conclusions:

    • The energy requirement for internal defibrillation with ICDs is stable over the long term.
    • ICDs maintain their effectiveness in terminating lethal ventricular arrhythmias after initial implantation.
    • Factors such as impedance, medications, or clinical events do not significantly alter the defibrillation threshold.