title: Is defibrillation testing necessary?
abstract: With advancements in implantable cardioverter defibrillator (ICD) technology, the practice of performing defibrillation threshold (DFT) testing at the time of implantation has been questioned. With availability of biphasic waveforms, active cans, and high-output devices, opponents claim that DFT testing is no longer necessary. Clinical trials demonstrating the efficacy of ICDs in prevention of sudden cardiac death have, however, all used some form of defibrillation testing. This debate is fueled by the absence of data from randomized prospective trials evaluating the role of DFT testing in predicting clinical shock efficacy or survival. This review discusses both sides of the argument.
authors.affiliation: Electrophysiology and Arrhythmia Services, Cooper University Hospital, Cooper Medical School of Rowan University, 426 Dorrance Building, 1 Cooper Plaza, Camden, NJ 08103, USA. Electronic address: russo-andrea@cooperhealth.edu.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Russo
authors.affiliation: Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: Mina K
authors.initials: MK
authors.lastname: Chung
mesh_terms: D001145:Arrhythmias, Cardiac / Q000191:economics / Q000628:therapy*; D003365:Costs and Cost Analysis; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D003935:Diagnostic Techniques, Cardiovascular / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data; D004554:Electric Countershock; D004812:Epidemiologic Methods; D019317:Evidence-Based Medicine; D006801:Humans; D011379:Prognosis; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000379:methods*; D012307:Risk Factors; D019564:Unnecessary Procedures / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000191:economics / Q000628:therapy
keywords: Defibrillation testing; Implantable cardioverter defibrillator; Sudden cardiac death