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Initial single-center experience with an advanced third-generation investigational defibrillator
R Lampert1, L Rosenfeld, C McPherson
1Yale University School of Medicine, Yale-New Haven Hospital, CT 06511, USA.
Pacing and Clinical Electrophysiology : PACE
|December 1, 1996
Summary
The CPI PRxII implantable cardioverter defibrillator (ICD) effectively treats ventricular arrhythmias with low defibrillation thresholds and antitachycardia pacing. Its stored electrograms enhance diagnostic capabilities for optimized patient therapy.
Area of Science:
- Cardiology
- Biomedical Engineering
- Electrophysiology
Background:
- The CPI PRxII is a novel, multitiered implantable cardioverter defibrillator (ICD).
- It delivers biphasic shocks, antitachycardia (ATP), and bradycardia pacing.
- The device stores electrograms from widely spaced shocking electrodes.
Purpose of the Study:
- To evaluate the efficacy and safety of the PRxII ICD in patients with ventricular arrhythmias.
- To assess the defibrillation threshold (DFT) and the effectiveness of ATP and shock therapy.
- To determine the diagnostic value of stored electrograms.
Main Methods:
- The PRxII was implanted in 58 patients between December 1993 and January 1995.
- Noninvasive predischarge electrophysiology study (EPS) was performed.
- Follow-up included monitoring of treated events and analysis of stored electrograms.
Main Results:
- Mean biphasic DFT was 10 J; successful nonthoracotomy implantation was achieved in all eligible patients.
- Antitachycardia pacing (ATP) successfully treated 97% of ventricular tachycardia (VT) events in the ATP zone.
- Stored electrograms confirmed VT in 111 of 148 available recordings and altered therapy in nine patients.
Conclusions:
- The PRxII ICD achieves low DFTs, eliminating the need for thoracotomy.
- It effectively treats ventricular arrhythmias using ATP and shock, with programming guided by noninvasive EPS.
- Stored electrograms significantly enhance diagnostic capabilities, leading to more effective treatment of ventricular arrhythmias.