open access

Vol 22, No 3 (2015)
Original articles
Published online: 2015-06-19
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Clinical impact of defibrillation testing at the time of implantable cardioverter-defibrillator insertion

Claudio Hadid, Felipe Atienza, Boris Strasberg, Ángel Arenal, Pablo Codner, Esteban González-Torrecilla, Tomás Datino, Tamara Percal, Jesús Almendral, Mercedes Ortiz, Raphael Martins, Nieves Martinez-Alzamora, Francisco Fernandez-Aviles
DOI: 10.5603/CJ.a2014.0062
·
Pubmed: 25179316
·
Cardiol J 2015;22(3):253-259.

open access

Vol 22, No 3 (2015)
Original articles
Published online: 2015-06-19

Abstract

Background: Ventricular fibrillation is routinely induced during implantable cardioverter-defibrillator insertion to assess defibrillator performance, but this strategy is experiencing a progressive decline. We aimed to assess the efficacy of defibrillator therapies and long-term outcome in a cohort of patients that underwent defibrillator implantation with and without defibrillation testing.

Methods: Retrospective observational series of consecutive patients undergoing initial defi­brillator insertion or generator replacement. We registered spontaneous ventricular arrhyth­mias incidence and therapy efficacy, and mortality.

Results: A total of 545 patients underwent defibrillator implantation (111 with and 434 without defibrillation testing). After 19 (range 9–31) months of follow-up, the death rate per observation year (4% vs. 4%; p = 0.91) and the rate of patients with defibrillator-treated ven­tricular arrhythmic events per observation year (with test: 10% vs. without test: 12%; p = 0.46) were similar. The generalized estimating equations-adjusted first shock probability of success in patients with test (95%; CI 88–100%) vs. without test (98%; CI 96–100%; p = 0.42) and the proportion of successful antitachycardia therapies (with test: 87% vs. without test: 80%; p = 0.35) were similar between groups. There was no difference in the annualized rate of failed first shock per patient and per shocked patient between groups (5% vs. 4%; p = 0.94).

Conclusions: In this observational study, that included an unselected population of patients with a defibrillator, no difference was found in overall mortality, first shock efficacy and rate of failed shocks regardless of whether defibrillation testing was performed or not.  

Abstract

Background: Ventricular fibrillation is routinely induced during implantable cardioverter-defibrillator insertion to assess defibrillator performance, but this strategy is experiencing a progressive decline. We aimed to assess the efficacy of defibrillator therapies and long-term outcome in a cohort of patients that underwent defibrillator implantation with and without defibrillation testing.

Methods: Retrospective observational series of consecutive patients undergoing initial defi­brillator insertion or generator replacement. We registered spontaneous ventricular arrhyth­mias incidence and therapy efficacy, and mortality.

Results: A total of 545 patients underwent defibrillator implantation (111 with and 434 without defibrillation testing). After 19 (range 9–31) months of follow-up, the death rate per observation year (4% vs. 4%; p = 0.91) and the rate of patients with defibrillator-treated ven­tricular arrhythmic events per observation year (with test: 10% vs. without test: 12%; p = 0.46) were similar. The generalized estimating equations-adjusted first shock probability of success in patients with test (95%; CI 88–100%) vs. without test (98%; CI 96–100%; p = 0.42) and the proportion of successful antitachycardia therapies (with test: 87% vs. without test: 80%; p = 0.35) were similar between groups. There was no difference in the annualized rate of failed first shock per patient and per shocked patient between groups (5% vs. 4%; p = 0.94).

Conclusions: In this observational study, that included an unselected population of patients with a defibrillator, no difference was found in overall mortality, first shock efficacy and rate of failed shocks regardless of whether defibrillation testing was performed or not.  

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Keywords

implantable cardioverter-defibrillator, defibrillation testing, ventricular fibrillation, defibrillator shocks, mortality

About this article
Title

Clinical impact of defibrillation testing at the time of implantable cardioverter-defibrillator insertion

Journal

Cardiology Journal

Issue

Vol 22, No 3 (2015)

Pages

253-259

Published online

2015-06-19

DOI

10.5603/CJ.a2014.0062

Pubmed

25179316

Bibliographic record

Cardiol J 2015;22(3):253-259.

Keywords

implantable cardioverter-defibrillator
defibrillation testing
ventricular fibrillation
defibrillator shocks
mortality

Authors

Claudio Hadid
Felipe Atienza
Boris Strasberg
Ángel Arenal
Pablo Codner
Esteban González-Torrecilla
Tomás Datino
Tamara Percal
Jesús Almendral
Mercedes Ortiz
Raphael Martins
Nieves Martinez-Alzamora
Francisco Fernandez-Aviles

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