Implantable cardioverter defibrillator with and without defibrillation threshold testing.
BACKGROUND
Defibrillation threshold (DFT) testing at the time of implantable cardioverter defibrillator (ICD) insertion is performed routinely. This practice is being reconsidered due to doubts about its ability to improve ICD efficacy and evidence that survival may not be affected by the test.


OBJECTIVE
To compare the outcome of ICD recipients who underwent DFT testing and those who did not.


METHODS
A total of 213 eligible patients were implanted with an ICD between 2004 and 2009. DFT testing was performed in 80 of them. We compared total mortality, appropriate and inappropriate ICD shocks, and anti-tachycardia pacing (ATP) events between DFT and non-DFT patients during a follow-up of 2 years.


RESULTS
On comparing the DFT and non-DFT groups, we found a 2 year mortality rate of 7.5% versus 8.3%, respectively (P = 0.8). Furthermore, 20.7% of patients in the DFT group and 12.4% in the non-DFT group had at least one episode of ICD shock (P = 0.15). With regard to ICD treatment (ICD shocks or ATP events), 57.7% in the DFT group and 64.2% in the non-DFT group received appropriate treatments (P = 0.78).


CONCLUSIONS
No significant differences in the incidence of 2 year mortality or percentage of ICD treatment emerged between the DFT and non-DFT groups.
Department of Cardiology, Rabin Medical Center (Beilinson Campus), Petah Tikva, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
Pablo
P
Codner
Roman
R
Nevzorov
Jairo
J
Kusniec
Moti
M
Haim
Ronit
R
Zabarski
Boris
B
Strasberg
D000368:Aged; D002304:Cardiac Pacing, Artificial; D017147:Defibrillators, Implantable; D004056:Differential Threshold; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012684:Sensory Thresholds; D019564:Unnecessary Procedures; D014693:Ventricular Fibrillation / Q000517:prevention & control / Q000628:therapy*