Cargando…

Defibrillation Threshold Testing for Right-sided Device Implants: A Review to Inform Shared Decision-making, in Association with the British Heart Rhythm Society

Prevention of sudden death using ICDs requires the reliable delivery of a high-energy shock to successfully terminate VF. Until more recently, the device implant procedure included conducting defibrillation threshold (DFT) testing involving VF induction and shock delivery to ensure efficacy. Large c...

Descripción completa

Detalles Bibliográficos
Autores principales: Pope, Michael TB, Paisey, John R, Roberts, Paul R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Radcliffe Cardiology 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326664/
https://www.ncbi.nlm.nih.gov/pubmed/37427305
http://dx.doi.org/10.15420/aer.2022.38
_version_ 1785069469367795712
author Pope, Michael TB
Paisey, John R
Roberts, Paul R
author_facet Pope, Michael TB
Paisey, John R
Roberts, Paul R
author_sort Pope, Michael TB
collection PubMed
description Prevention of sudden death using ICDs requires the reliable delivery of a high-energy shock to successfully terminate VF. Until more recently, the device implant procedure included conducting defibrillation threshold (DFT) testing involving VF induction and shock delivery to ensure efficacy. Large clinical trials, including SIMPLE and NORDIC ICD, have subsequently demonstrated that this is unnecessary, with a practice of omitting DFT testing having no impact on subsequent clinical outcomes. However, these studies specifically excluded patients requiring devices implanted on the right side, in whom the shock vector is significantly different and smaller studies suggest a higher DFT. In this review, the data regarding the use of DFT testing, focusing on right-sided implants, and the results of a survey of current UK practice are presented. In addition, a strategy of shared decision-making when it comes to deciding on the use of DFT testing during right-sided ICD implant procedures is proposed.
format Online
Article
Text
id pubmed-10326664
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Radcliffe Cardiology
record_format MEDLINE/PubMed
spelling pubmed-103266642023-07-08 Defibrillation Threshold Testing for Right-sided Device Implants: A Review to Inform Shared Decision-making, in Association with the British Heart Rhythm Society Pope, Michael TB Paisey, John R Roberts, Paul R Arrhythm Electrophysiol Rev Implantable Devices Prevention of sudden death using ICDs requires the reliable delivery of a high-energy shock to successfully terminate VF. Until more recently, the device implant procedure included conducting defibrillation threshold (DFT) testing involving VF induction and shock delivery to ensure efficacy. Large clinical trials, including SIMPLE and NORDIC ICD, have subsequently demonstrated that this is unnecessary, with a practice of omitting DFT testing having no impact on subsequent clinical outcomes. However, these studies specifically excluded patients requiring devices implanted on the right side, in whom the shock vector is significantly different and smaller studies suggest a higher DFT. In this review, the data regarding the use of DFT testing, focusing on right-sided implants, and the results of a survey of current UK practice are presented. In addition, a strategy of shared decision-making when it comes to deciding on the use of DFT testing during right-sided ICD implant procedures is proposed. Radcliffe Cardiology 2023-04-14 /pmc/articles/PMC10326664/ /pubmed/37427305 http://dx.doi.org/10.15420/aer.2022.38 Text en Copyright © 2023, Radcliffe Cardiology https://creativecommons.org/licenses/by-nc/4.0/This work is open access under the CC-BY-NC 4.0 License which allows users to copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly.
spellingShingle Implantable Devices
Pope, Michael TB
Paisey, John R
Roberts, Paul R
Defibrillation Threshold Testing for Right-sided Device Implants: A Review to Inform Shared Decision-making, in Association with the British Heart Rhythm Society
title Defibrillation Threshold Testing for Right-sided Device Implants: A Review to Inform Shared Decision-making, in Association with the British Heart Rhythm Society
title_full Defibrillation Threshold Testing for Right-sided Device Implants: A Review to Inform Shared Decision-making, in Association with the British Heart Rhythm Society
title_fullStr Defibrillation Threshold Testing for Right-sided Device Implants: A Review to Inform Shared Decision-making, in Association with the British Heart Rhythm Society
title_full_unstemmed Defibrillation Threshold Testing for Right-sided Device Implants: A Review to Inform Shared Decision-making, in Association with the British Heart Rhythm Society
title_short Defibrillation Threshold Testing for Right-sided Device Implants: A Review to Inform Shared Decision-making, in Association with the British Heart Rhythm Society
title_sort defibrillation threshold testing for right-sided device implants: a review to inform shared decision-making, in association with the british heart rhythm society
topic Implantable Devices
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326664/
https://www.ncbi.nlm.nih.gov/pubmed/37427305
http://dx.doi.org/10.15420/aer.2022.38
work_keys_str_mv AT popemichaeltb defibrillationthresholdtestingforrightsideddeviceimplantsareviewtoinformshareddecisionmakinginassociationwiththebritishheartrhythmsociety
AT paiseyjohnr defibrillationthresholdtestingforrightsideddeviceimplantsareviewtoinformshareddecisionmakinginassociationwiththebritishheartrhythmsociety
AT robertspaulr defibrillationthresholdtestingforrightsideddeviceimplantsareviewtoinformshareddecisionmakinginassociationwiththebritishheartrhythmsociety