Related Experiment Video
Updated: Jan 23, 2026
Integration of Brain Tissue Saturation Monitoring in Cardiopulmonary Exercise Testing in Patients with Heart Failure
Published on: October 1, 2019
Impact of defibrillation threshold testing on burden of heart failure hospitalizations
Baris Akdemir1, Yanhui Li1,2, Balaji Krishnan1
1Cardiovascular Division, Cardiac Arrhythmia Center, University of Minnesota, MN, Minneapolis, USA.
Insights
Defibrillation threshold testing (DT) after implantable cardioverter defibrillator (ICD) implantation did not increase mortality or shocks. However, DT was linked to higher heart failure hospitalizations within 30 days.
Area of Science:
- Cardiology
- Medical Devices
- Heart Failure Management
Background:
- Defibrillation threshold testing (DT) following implantable cardioverter defibrillator (ICD) implantation is standard practice.
- Previous studies indicate DT does not improve mortality rates.
- The effect of DT on heart failure (HF) hospitalizations remains unclear.
Purpose of the Study:
- To investigate the association between DT and the burden of HF hospitalizations post-ICD implantation.
- To evaluate the impact of DT on other adverse outcomes, including mortality, stroke, and ICD shocks.
Main Methods:
- Retrospective analysis of 501 patients undergoing ICD implantation or generator change between 2008 and 2014.
- Primary outcome: HF hospitalizations within 30 days post-implantation.
- Secondary outcomes: 30-day and 1-year mortality, stroke, and ICD shocks.
Main Results:
- 62% of patients (n=311) were in the DT+ group, 38% (n=190) in the DT- group.
- DT+ group had significantly higher 30-day HF hospitalization rates (17.4% vs 4.7%, p < .0001).
- No significant differences were observed in 30-day mortality, stroke, ICD shocks, or 1-year mortality between groups.
Conclusions:
- DT following ICD implantation or generator replacement is associated with increased HF hospitalization rates within 30 days.
- DT was not associated with increased mortality, stroke, or ICD shocks at 30 days or mortality at 1 year.
- Further randomized studies are needed to validate these findings on HF hospitalizations.
Abstract:
Background: Defibrillation threshold testing (DT) following implantable cardioverter defibrillator (ICD) implantation has not shown to improve mortality. However, the impact of DT on burden of heart failure (HF) hospitalisations has not been well defined.Methods: We studied retrospectively consecutive patients who underwent ICD implantation or generator change between 2008 and 2014. Primary outcome was burden of HF hospitalisations within 30 days following implantation. Secondary outcomes were mortality, stroke, and ICD shock within 30 days and one-year mortality.Results: Three hundred and eleven of 501 patients (62%) were in DT+ group versus 190 (38%) were in DT- group. The percentage of new implantations was higher in DT+ group than in DT- group (69% vs 39%, p < .001) but the distributions of NYHA function classes were similar between two groups. The burden of HF hospitalisations at 30-days was significantly higher in DT+ group than in DT- group (17.4% vs 4.7%, HR 0.842, 95% CI 0.774-0.915, p < .0001). No difference in mortality, stroke or ICD shocks was found between two groups at 30 days and mortality at 1 year.Conclusions: DT after new ICD or generator replacement was associated with increased HF hospitalisation rates at 30 days after ICD implant in a non-trial HF population. However, there was no association between DT and mortality, stroke and ICD shocks at 30 days or mortality at 1 year. The increased burden of HF hospitalisation in this observational study requires validation by randomised studies.
Related Concept Videos
01:29Heart Failure II: Pathophysiology
00:59Hospitals-II
Nurses that work in...
01:17Pathophysiology of Heart Failure
01:27Heart Failure I: Introduction
01:28Hospitals-I
01:22Heart Failure VI: Adjunct Therapies