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The role of defibrillation testing.

Guy Amit1, Jeff S Healey2

  • 1McMaster University, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.

Cardiac Electrophysiology Clinics
|August 26, 2015
PubMed
Summary
This summary is machine-generated.

Defibrillation testing (DT) during implantable cardioverter-defibrillator (ICD) implantation is declining due to high first-shock efficacy and serious complications. Many centers now forgo DT, questioning its necessity in modern practice.

Keywords:
Defibrillation testingFibrillationImplantable defibrillatorVentricular tachycardia

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Defibrillation testing (DT) has been a standard procedure during implantable cardioverter-defibrillator (ICD) implantation.
  • Recent evidence suggests high first-shock efficacy for clinical arrhythmias without DT.
  • DT is associated with rare but severe complications.

Purpose of the Study:

  • To evaluate the changing trends and rationale behind the decline of DT during ICD implantation.
  • To assess the impact of DT on patient outcomes and safety.

Main Methods:

  • Review of published series and reports over the last 10 years.
  • Analysis of trends in DT utilization globally.
  • Comparison of first-shock efficacy with and without DT.

Main Results:

  • A significant decline in DT rates globally, with less than 50% of patients undergoing the procedure in many regions.
  • Published data indicate a high rate of first-shock efficacy for clinical ventricular arrhythmias.
  • Reports highlight uncommon but serious complications associated with DT.

Conclusions:

  • The traditional practice of DT during ICD implantation is being re-evaluated.
  • The declining use of DT reflects growing confidence in device efficacy and concerns over potential complications.
  • Further research may clarify optimal strategies for ICD implantation and testing.