title: Defibrillation Testing Strategies of Pediatric and Adult Congenital Electrophysiologists during ICD Implantation.
abstract: BACKGROUND
  Recently, there has been an increasing number of internal medicine-trained electrophysiologists who choose not to test for acute defibrillation efficacy during implantable cardioverter defibrillator (ICD) implantation. It is not known whether this same trend is seen in pediatric electrophysiologists, who care primarily for patients with congenital heart disease or primary electrical problems.
  
  
  METHODS
  Through a 14-question survey created on Survey Monkey, we asked the members of the Pediatric and Adult Congenital Electrophysiology Society (PACES) for their approach to ICD implantation. In particular, respondents were asked for their individual practice preferences on testing for acute defibrillation efficacy, including methods used for testing.
  
  
  RESULTS
  There were 108 survey respondents. Thirty-nine percent test acute defibrillation efficacy at all implants, while 46% test in most patients, barring any clinical concerns. Another 14% routinely test during initial ICD system implants but not during generator changes with existing leads. Less than 1% of respondents do not routinely test acute defibrillation efficacy.
  
  
  CONCLUSIONS
  The practice preferences of pediatric electrophysiologists in evaluating for acute defibrillation efficacy during ICD implants are in contrast to the recent trend in their internal medicine-trained counterparts. More studies are needed to determine if practice changes should be considered in the pediatric and adult congenital patient population.
authors.affiliation: Nicklaus Children's Hospital Heart Program, Miami Children's Health System, Miami, Florida.
authors.forename: Sherrie Joy A
authors.initials: SJ
authors.lastname: Baysa
authors.affiliation: Nicklaus Children's Hospital Heart Program, Miami Children's Health System, Miami, Florida.
authors.forename: Melissa
authors.initials: M
authors.lastname: Olen
authors.affiliation: Nicklaus Children's Hospital Heart Program, Miami Children's Health System, Miami, Florida.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Kanter
authors.affiliation: Nicklaus Children's Hospital Heart Program, Miami Children's Health System, Miami, Florida.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Fishberger
mesh_terms: D000293:Adolescent; D000328:Adult; D000072096:Cardiologists / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D019544:Equipment Failure Analysis / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D000072143:Pediatricians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D019919:Prosthesis Implantation / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult
keywords: defibrillation - ICD; electrophysiology - clinical; pediatrics