Ventricular Fibrillation Conversion Testing After Implantation of a Subcutaneous Implantable Cardioverter Defibrillator: Report From the National Cardiovascular Data Registry

Circulation
Daniel J FriedmanSana M Al-Khatib

Abstract

Compared with transvenous implantable cardioverter defibrillators (ICDs), subcutaneous (S)-ICDs require a higher energy for effective defibrillation. Although ventricular fibrillation conversion testing (CT) is recommended after S-ICD implantation to ensure an adequate margin between the defibrillation threshold and maximum device output (80J), prior work found that adherence to this recommendation is declining. We studied first-time recipients of S-ICDs (between September 28, 2012, and April 1, 2016) in the National Cardiovascular Database Registry ICD Registry to determine predictors of use of CT, predictors of an insufficient safety margin (ISM, defined as ventricular fibrillation conversion energy >65J) during testing, and inhospital outcomes associated with use of CT. Multivariable logistic regression analysis was used to predict use of CT and ISM. Inverse probability weighted logistic regression analysis was used to examine the association between use of CT and inhospital adverse events including death. CT testing was performed in 70.7% (n=5624) of 7960 patients with S-ICDs. Although deferral of CT was associated with several patient characteristics (including increased body mass index, increased body surface area, severe...Continue Reading

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Citations

Aug 10, 2019·Pacing and Clinical Electrophysiology : PACE·Beatriz León SalasPedro Serrano-Aguilar
Nov 30, 2019·Journal of Cardiovascular Electrophysiology·Matteo ZiacchiAndrea Droghetti
Jun 17, 2020·Expert Review of Cardiovascular Therapy·Muhammad R AfzalRaul Weiss
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Sep 15, 2020·Pacing and Clinical Electrophysiology : PACE·Prabhpreet SinghRaul Weiss
Sep 25, 2020·Clinical Journal of the American Society of Nephrology : CJASN·Patrick H PunSana M Al-Khatib
Mar 20, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Nils BögeholzLars Eckardt
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Dec 10, 2020·Journal of Cardiovascular Electrophysiology·Danilo RicciardiGiovanni Battista Forleo
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Jan 23, 2021·JACC. Clinical Electrophysiology·Amar MistryRavi K Pathmanathan
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May 11, 2021·Journal of Cardiovascular Electrophysiology·Pietro FranciaMatteo Ziacchi
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Dec 31, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Pietro FranciaCamillo Autore

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