Relation of echocardiographic wall motion score index and response to dobutamine stress to defibrillation threshold at the time of implantation of a cardiac defibrillator.
Predictors of defibrillation threshold (DFT) at implantation remain poorly defined. It was hypothesized that a greater wall motion score index (WMSI) at rest on echocardiography and an ischemic or biphasic response on dobutamine stress echocardiography (DSE) would predict a greater DFT. Consecutive patients who underwent implantable cardiac-defibrillator implantation underwent echocardiography and DSE. DFT at implantation was assessed using the step-down method. Thirteen men aged 68 +/- 10 years with left ventricular ejection fractions of 28 +/- 10% participated in the study. DFTs ranged from 5 to 25 J (mean 14 +/- 8). A WMSI at rest of > or = 2.5 had a 71% positive predictive value and an 83% negative predictive value for a DFT > or = 15 J. An ischemic or biphasic response during DSE did not predict a greater DFT at implantation.
Kizilbash
Ali M
AM
University of Texas Southwestern Medical Center, USA.
Grayburn
Paul A
PA
Anand
Prasad
P
Kowal
Robert C
RC
Page
Richard L
RL
Smith
Kim
K
Hamdan
Mohamed H
MH
D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging* / Q000601:surgery*; D017147:Defibrillators, Implantable; D004280:Dobutamine; D025401:Echocardiography, Stress; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D019919:Prosthesis Implantation; D013318:Stroke Volume / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome
D004280:Dobutamine