Intraoperative Defibrillation Testing of Subcutaneous Implantable Cardioverter‐Defibrillator Systems—A Simple Issue?
Background: The results of the recently published randomized SIMPLE trial question the role of routine intraoperative defibrillation testing. However, testing is still recommended during implantation of the entirely subcutaneous implantable cardioverter‐defibrillator (S‐ICD) system. To address the q...
Verfasser: | |
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FB/Einrichtung: | FB 05: Medizinische Fakultät |
Dokumenttypen: | Artikel |
Medientypen: | Text |
Erscheinungsdatum: | 2016 |
Publikation in MIAMI: | 24.03.2016 |
Datum der letzten Änderung: | 16.04.2019 |
Angaben zur Ausgabe: | [Electronic ed.] |
Quelle: | Journal of the American Heart Association (JAHA) 5 (2016) 3, e003181, 1-7 |
Schlagwörter: | defibrillator testing; device complications; implantable cardioverter-defibrillator, subcutaneous; sudden cardiac death |
Fachgebiet (DDC): | 610: Medizin und Gesundheit |
Lizenz: | CC BY-NC 4.0 |
Sprache: | English |
Anmerkungen: | Finanziert durch den Open-Access-Publikationsfonds 2015/2016 der Westfälischen Wilhelms-Universität Münster (WWU Münster). |
Format: | PDF-Dokument |
ISSN: | 2047-9980 |
URN: | urn:nbn:de:hbz:6-86249707176 |
Weitere Identifikatoren: | DOI: 10.1161/JAHA.115.003181 |
Permalink: | https://nbn-resolving.de/urn:nbn:de:hbz:6-86249707176 |
Onlinezugriff: | jaha_2016_5_3_e003181.pdf |
Background: The results of the recently published randomized SIMPLE trial question the role of routine intraoperative defibrillation testing. However, testing is still recommended during implantation of the entirely subcutaneous implantable cardioverter‐defibrillator (S‐ICD) system. To address the question of whether defibrillation testing in S‐ICD systems is still necessary, we analyzed the data of a large, standard‐of‐care prospective single‐center S‐ICD registry. // Methods and Results: In the present study, 102 consecutive patients received an S‐ICD for primary (n=50) or secondary prevention (n=52). Defibrillation testing was performed in all except 4 patients. In 74 (75%; 95% CI 0.66–0.83) of 98 patients, ventricular fibrillation was effectively terminated by the first programmed internal shock. In 24 (25%; 95% CI 0.22–0.44) of 98 patients, the first internal shock was ineffective and further internal or external shock deliveries were required. In these patients, programming to reversed shock polarity (n=14) or repositioning of the sensing lead (n=1) or the pulse generator (n=5) led to successful defibrillation. In 4 patients, a safety margin of