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Defibrillation threshold testing during implantable cardioverter defibrillator implantation: 5-year follow-up

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

Defibrillation threshold (DFT) testing is a routine practice in some Asian countries for patients receiving an implantable cardioverter defibrillator (ICD). However, there are few long-term data about the necessity of intraoperative DFT testing in an Asian population. We investigated the safety of DFT testing and the long-term clinical outcomes in Asian patients undergoing ICD implantation.

Methods

All patients undergoing de novo transvenous ICD implantation were randomized to undergo periprocedural DFT testing. The study included 67 patients (50 males; 51.5 ± 16.9 years) who underwent ICD implantation with (n = 33) or without (n = 34) intraoperative DFT testing between March 2012 and February 2014. We compared first-shock success, composite safety end points (the sum of complications recorded at 30 days), arrhythmic death, and all-cause mortality.

Results

The baseline clinical characteristics and the procedural-related adverse event rate (3.0% with DFT vs. 0% with non-DFT, p = 0.214) did not differ between groups. The programmed output of the first shock was lower in the DFT testing group (22.9 ± 4.4 J vs. 25.3 ± 5.4 J, p = 0.007). However, there were no significant differences between groups for all-cause mortality (12.1% vs. 17.6%, p = 0.526) or first-shock success rate for ventricular arrhythmia (100% vs. 88.2%, p = 0.471).

Conclusions

There were no between-group differences in periprocedural safety, complications, and long-term clinical outcomes. Our results suggest that DFT testing in Asian patients allows reduction of the programmed output of the first shock, but does not affect long-term clinical outcomes.

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Funding

This study was supported by research fund from Chosun University, 2018.

Author information

Authors and Affiliations

  1. Cardiovascular Division, Chosun University Hospital, 365, Pilmun daero, Dong-gu, Gwangju, South Korea

    Sung Soo Kim

  2. Department of Cardiovascular Medicine, Chonnam National University Medical School, 42, Jebong-ro, Dong-gu, Gwangju, 61469, South Korea

    Hyung Wook Park, Hyung Ki Jeong, Ki Hong Lee, Nam Sik Yoon & Jeong Gwan Cho

Authors
  1. Sung Soo Kim
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  2. Hyung Wook Park
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  3. Hyung Ki Jeong
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  4. Ki Hong Lee
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  5. Nam Sik Yoon
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  6. Jeong Gwan Cho
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Corresponding author

Correspondence to Hyung Wook Park.

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This study was approved by our institutional review board (CNUH-2012-175) and was designed to assess the risk of perioperative complications and estimate the long-term (5 years) clinical event rates.

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The authors declare that there is no conflict of interest.

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Kim, S.S., Park, H.W., Jeong, H.K. et al. Defibrillation threshold testing during implantable cardioverter defibrillator implantation: 5-year follow-up. J Interv Card Electrophysiol 60, 485–491 (2021). https://doi.org/10.1007/s10840-020-00733-x

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  • DOI: https://doi.org/10.1007/s10840-020-00733-x

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