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


METHODS
We analyzed 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 analyzed 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 or VF was not induced in 3 patients (37.5%). During the mean follow-up of 1 approximately 7 (4.2+/-1.9) years, 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 energy 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.


CONCLUSIONS
No application of routine DFT may avoid 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.
Liu
Qiming
Q
Department of Cardiology, Central South University, Changsha 410011, China. qimingliu@yahoo.com.cn
Zhou
Shenghua
S
Qi
Shushan
S
Zeng
Gaofeng
G
Ma
Xiaofeng
X
Huang
He
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D017147:Defibrillators, Implantable / Q000009:adverse effects* / Q000592:standards; D004554:Electric Countershock / Q000009:adverse effects* / Q000592:standards; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012684:Sensory Thresholds; D019564:Unnecessary Procedures; D014693:Ventricular Fibrillation / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult