Predischarge arrhythmia induction testing of implantable defibrillators may be unnecessary in selected cases

The American Journal of Cardiology
D N WeissM Rosenbaum

Abstract

Complete postoperative evaluation of implantable cardioverter-defibrillators (ICDs) before discharge, including arrhythmia induction, has been the standard since their introduction. Whereas the original ICDs provided little telemetered information and used separate pace-sense and defibrillation leads, modern, third-generation devices provide pace-sense function information in addition to other data and are used in conjunction with integrated transvenous endocardial leads that combine pace-sense and defibrillation function. Changes in lead position, which can potentially result in either an inability to detect fibrillation or to terminate it, should be mirrored by changes in resting pace-sense function. Thus, for newer ICDs implanted with integrated endocardial lead systems, it is possible that in at least some cases predischarge arrhythmia inductions can be avoided. Two hundred patients receiving third-generation ICDs in conjunction with integrated transvenous leads were evaluated before discharge. Defibrillation detection or termination problems were seen in 8. Declines in resting R-wave amplitude and pacing impedance were significantly associated with such complications (-7 +/- 5 vs -0.3 +/- 2.3 mV [p <0.0001] and -158 +/- 13...Continue Reading

References

Sep 1, 1995·Journal of the American College of Cardiology·D SchwartzmanF E Marchlinski
Jun 1, 1994·Pacing and Clinical Electrophysiology : PACE·H H HsiaF E Marchlinski

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Citations

Feb 3, 2005·Pacing and Clinical Electrophysiology : PACE·Alexander DelvecchioEugen C Palma
Oct 3, 2002·The American Journal of Cardiology·Paveljit S BindraDavid Keane
Aug 3, 2007·Pacing and Clinical Electrophysiology : PACE·Bengt SandstedtNils Edvardsson
Feb 17, 1999·Pacing and Clinical Electrophysiology : PACE·K G LurieD G Benditt

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