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Clinical and research medicine: Pace and Cardiac Electrophysiology
e0564 Efficacy and safety of implantable cardioverter defibrillatoravoiding routine defibrillation threshold testing
  1. Liu Qiming1,
  2. Zhou Shenghua1,
  3. Qi Shushan1,
  4. Zeng Gaofeng2,
  5. Ma Xiaofeng3,
  6. Huang He4
  1. 1Department of Cardiology, Second Xiangya Hospital, Central South University, Changsha
  2. 2Department of Cardiology, Second Affiliated Hospital, Nanhua University, Henyang Hunan
  3. 3Department of Cardiology, Nanhua Hospital, Nanhua University, Henyang Hunan
  4. 4Department of Cardiology, Xiangtan Central Hospital, Xiangtan Hunan

Abstract

Objective To evaluate the efficacy and safety of implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy-defibrillators (CRT-D) avoiding defibrillation threshold (DFT) testing when treating ventricular tachycardia (VT) or ventricular fibrillation (VF).

Methods We analysed a continuous database of the 21 patients who had avoided DFT during ICD implantation from Oct. 1999 to Aug. 2008. Follow-up data were completed and analysed in the 21 patients with ICD implantation.

Results ICDs were implanted successfully in 17 patients with VT or VF, and CRT-D were implanted successfully in 4 myocardiopathy patients with severe heart failure who avoided DFT during ICD or CRT-D implantation. Eight patients accepted DFT 1 week later, VT orVF was not induced in 3 patients (37.5 %). During the mean follow-up of 1–7 (4.2±1.9) yrs, malignant ventricular arrythmia was recorded in 16 patients. Among them, 89 episodes were successfully terminated by defbrillation (100%), 120 VT events were terminated by the first run of antitachycardia pacing (51.1%) and 22 by low engery cardioversion (59.2%). All patients took antiarrhycardia drugs after ICD or CRT-D implantation. No patient died from malignant ventricular arrythmia during the follow-up.

Conclusion No application of routine DFT may aviod complications associated with DFT during ICD or CRT-D implantation. ICD or CRT-D implantation may effectively treat fatal ventricular tachyarrhythmias and prevent sudden cardiac death.

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