Defibrillation testing during implantation of cardioverter–defibrillators is controversial because of potential safety concerns and a lack of evidence for the effectiveness of the procedure. New data from the SAFE-ICD study is helpful, but does not completely resolve the issue.
References
Fotuhi, P. C., Epstein, A. E. & Ideker, R. E. Energy levels for defibrillation: what is of real clinical importance? Am. J. Cardiol. 83, 24–33 (1999).
Poole, J. E. et al. Prognostic Importance of defibrillator shocks in patients with heart failure. N. Engl. J. Med. 359, 1009–1017 (2008).
Brignole, M. et al. Clinical evaluation of defibrillation testing in an unselected population of 2,120 consecutive patients undergoing first implantable cardioverter–defibrillator implant. J. Am. Coll. Cardiol. 60, 981–987 (2012).
Mann, D. E. et al. The Low Energy Safety Study (LESS): rationale, design, patient characteristics, and device utilization. Am. Heart J. 143, 199–204 (2002).
Birnie, D. et al. Complications associated with defibrillation threshold testing: the Canadian experience. Heart Rhythm 5, 387–390 (2008).
Zipes, D. P. Electrophysiological mechanisms involved in ventricular fibrillation. Circulation 52 (Suppl. 6), III120–III130 (1975).
Wharton, J. M. et al. Cardiac potential and potential gradient fields generated by single, combined, and sequential shocks during ventricular defibrillation. Circulation 85, 1510–1523 (1992).
Nair, K. et al. Intramural activation during early human ventricular fibrillation. Circ. Arrhythm. Electrophysiol. 4, 692–703 (2011).
US National Library of Medicine. ClinicalTrials.gov[online], (2011).
US National Library of Medicine. ClinicalTrials.gov[online], (2011).
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Michael R. Gold is or has been a consultant for, a member of the speakers' bureau of, and received grant or research support from, Boston Scientific, Medtronic, Sorin Group, and St. Jude Medical. J. Lacy Sturdivant declares no competing interests.
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Sturdivant, J., Gold, M. Is defibrillation testing of ICDs necessary?. Nat Rev Cardiol 9, 618–619 (2012). https://doi.org/10.1038/nrcardio.2012.144
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DOI: https://doi.org/10.1038/nrcardio.2012.144
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