ArticleJournal of the American Heart Association2016
Intraoperative Defibrillation Testing of Subcutaneous Implantable Cardioverter-Defibrillator Systems-A Simple Issue?
Article in Journal of the American Heart Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 32 citations in OpenAlex.
- Long-Term Follow-Up of the S-ICD: A 10-Years Follow-Up Study of a Large Single Center Cohort.Pacing and clinical electrophysiology : PACE · 2025Article
- Defibrillation Testing in Patients Undergoing Replacement of the S-ICD Generator: Is There Still a Need?Pacing and clinical electrophysiology : PACE · 2025Article
- Article
- Real-Life Inter-Rater Variability of the PRAETORIAN Score Values.International journal of environmental research and public health · 2022Article
- Defibrillation testing during implantation of the subcutaneous implantable cardioverter-defibrillator: a necessary standard or becoming redundant?Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2020Review
- New Therapy, New Complications.JACC. Case reports · 2020Article
- Follow-up of the first patients with a totally subcutaneous ICD in Germany from implantation till battery depletion.Clinical research in cardiology : official journal of the German Cardiac Society · 2019Article
- [Subcutaneous implantable cardioverter-defibrillator : Current status and perspectives].Herzschrittmachertherapie & Elektrophysiologie · 2018Review
- [Leadless pacemakers and subcutaneously implantable cardioverter defibrillators].Der Internist · 2018Review
- Right versus left parasternal electrode position in the entirely subcutaneous ICD.Clinical research in cardiology : official journal of the German Cardiac Society · 2018Article
- Subcutaneous Implantable Cardioverter Defibrillators Implantation Without Defibrillation Threshold Testing: A Single Center Experience.Cardiology research · 2017Article
- Predictors of Elevated Defibrillation Threshold with the Subcutaneous Implantable Cardioverter-defibrillator.The Journal of innovations in cardiac rhythm management · 2017Article
- Intraoperative Defibrillation Testing of Subcutaneous Implantable Cardioverter-Defibrillator Systems-A Simple Issue?Journal of the American Heart Association · 2016Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 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
resultsIn 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 <10 J was not attained. Nevertheless, in these 4 patients, ventricular arrhythmias were effectively terminated with an internal 80-J shock.
conclusionsAlthough it has been shown that defibrillation testing is not necessary in transvenous ICD systems, it seems particular important for S-ICD systems, because in nearly 25% of the cases the primary intraoperative test was not successful. In most cases, a successful defibrillation could be achieved by changing shock polarity or by optimizing the shock vector caused by the pulse generator or lead repositioning.
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