Abstract
Monophasic defibrillation thresholds rise over time with a variety of lead systems. These chronic changes are attenuated or eliminated by biphasic waveforms, although the effect appears dependent upon the lead system. With the downsizing of pulse generator size to allow for routine pectoral implantation, active can lead systems have now become standard. However, the temporal stability of such lead systems has not been evaluated previously. This study was a prospective assessment of the changes of active pectoral defibrillation thresholds over time. Thresholds were measured at implant, predischarge, and at a mean follow-up of 50 days in 46 patients with a uniform testing protocol and shock polarity. The lead system was a dual-coil Endotak DSP lead with an active pectoral pulse generator. Defibrillation thresholds were 9.9+/-5.5 J at implantation, 8.5+/-6.0 J predischarge, and 7.6+/-5.5 J at follow-up (ANOVA, P = 0.007). Moreover, only two patients developed an increased threshold > 5 J, and no patient had an inadequate safety margin at follow-up. These results indicate that active pectoral defibrillation thresholds are stable over the first 2 months postimplantation and question the need for routine serial defibrillation thresho...Continue Reading
References
Jun 1, 1992·Pacing and Clinical Electrophysiology : PACE·I Singer, D Lang
Nov 1, 1987·The American Journal of Cardiology·T GuarnieriM Mirowski
May 1, 1986·American Heart Journal·M F RattesG J Klein
Nov 15, 1995·Circulation·G K JonesG H Bardy
Aug 1, 1995·The American Journal of Cardiology·D T MartinF J Venditti
Sep 1, 1995·Journal of the American College of Cardiology·D SchwartzmanF E Marchlinski
Jan 1, 1993·Pacing and Clinical Electrophysiology : PACE·R FrameJ D Fisher
Jan 1, 1995·Journal of Cardiovascular Electrophysiology·J E PooleG Johnson
Jun 1, 1994·Pacing and Clinical Electrophysiology : PACE·H H HsiaF E Marchlinski
Jan 1, 1994·Circulation·F J VendittiS Bowen
Aug 1, 1993·Circulation·G H BardyB Hofer
Aug 1, 1993·Circulation·R Zucchi
Jun 1, 1996·Journal of Cardiovascular Electrophysiology·D SchwartzmanF E Marchlinski
Jun 1, 1996·Journal of Cardiovascular Electrophysiology·M R Gold, S R Shorofsky
Aug 1, 1996·The American Journal of Cardiology·R V TummalaM R Gold
Aug 1, 1996·The American Journal of Cardiology·S R Shorofsky, M R Gold
Sep 1, 1996·The American Journal of Cardiology·M R GoldS R Shorofsky
Feb 15, 1997·The American Journal of Cardiology·M M KirkM R Gold
Jun 15, 1997·The American Journal of Cardiology·M R GoldS R Shorofsky
Jul 1, 1997·Journal of the American College of Cardiology·M R GoldS R Shorofsky
Aug 19, 1997·Circulation·S A StrickbergerF Morady
Citations
Feb 17, 1999·Pacing and Clinical Electrophysiology : PACE·C ButterJ Neuzner
Jun 29, 2000·Scandinavian Cardiovascular Journal : SCJ·M KesekC Blomström-Lundqvist
Jun 1, 2012·Cardiac Electrophysiology Clinics·Frank A Cuoco, Michael R Gold
Jun 19, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Carl R ReynoldsMichael R Gold
Apr 28, 2007·Pacing and Clinical Electrophysiology : PACE·Charles D SwerdlowPaul J Degroot
Jan 15, 2009·Pacing and Clinical Electrophysiology : PACE·Ron D B SimonMichael R Gold
Nov 3, 2010·Pacing and Clinical Electrophysiology : PACE·William H SauerPaul D Varosy
May 1, 2002·Circulation·Michael R GoldStephen Hahn
Jun 27, 2000·Journal of Cardiovascular Electrophysiology·P A FriedmanM S Stanton
Apr 25, 2003·Pacing and Clinical Electrophysiology : PACE·Joerg CarlssonJoerg Neuzner