Clinical Usefulness of Electrophysiologic Study (EPS)-Guided Risk Stratification for Life-Threatening Arrhythmia in Patients With Heart Failure

Sasaki, Satoshi; Niwano, Shinichi; Fukaya, Hidehira; Yuge, Masaru; Imaki, Ryuta; Inomata, Takayuki; Izumi, Tohru

doi:10.1536/ihj.48.155

Int. Heart J.

2007

DOI: 10.1536/ihj.48.155

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Clinical Usefulness of Electrophysiologic Study (EPS)-Guided Risk Stratification for Life-Threatening Arrhythmia in Patients With Heart Failure

Satoshi Sasaki

Shinichi Niwano

Hidehira Fukaya

et al.

Abstract: SUMMARYBackground: Ventricular tachyarrhythmia is one of the most important factors deter-

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“…[1][2][3] Ventricular defibrillation testing (DFT) at the time of device implantation is considered a standard and required procedure. 4,5) Repeated episodes of circulatory arrest due to induced VF can cause cerebral nervous system hypoperfusion.…”

mentioning

confidence: 99%

<b>Defibrillation Testing and Early Neurologic Outcome</b>

Karaoğuz¹,

Altln²,

Atbaşoğlu

et al. 2008

Int. Heart J.

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SUMMARYDuring implantable cardioverter-defibrillator (ICD) implantation, ventricular defibrillation testing (DFT) is considered a standard procedure. This procedure often requires multiple ventricular fibrillation (VF) inductions. These repeated short episodes of circulatory arrest with global cerebral ischemia may cause neurological damage. In the present study, patients undergoing initial ICD implantation and limited induction of VF for defibrillation safety margin testing were evaluated for pre-and postoperative cognitive and neurologic functions. In addition, the serum neuron specific enolase (NSE) level, which is a biochemical marker of cerebral injury, was evaluated.The study was performed on 16 patients undergoing initial elective transvenous insertion of an ICD. A neurologic examination and cognitive assessment tests were performed 24 to 48 hours before and after ICD. NSE was determined before (NSE 1) and at the end of the surgery (NSE 2), as well as 2 hours (NSE 3), 24 hours (NSE 4), and 48 hours (NSE 5) after implantation.A total of 29 internal shocks (average, 1.8 ± 0.4) with energy ranging from 14 to 41 J (mean, 20 ± 5; median, 20 J ) were delivered in the ICD group patients. In one patient, 3 external (50, 200 and 360 J) shocks were required for fast VT induced during ICD lead positioning. The mean duration of VF was 10 ± 4 seconds and the mean cumulative time in VF was 16 ± 5 seconds. The mean recovery time between VFs was 5.3 ± 0.6 minutes. NSE levels were not different from the baseline at any time point in the patients of the group that completed the 48-hour observation period (P > 0.05). The patients did not report any new neurological symptoms after ICD implantation, and repeat examination after the procedure showed no abnormal findings other than those detected in the previous one. There were no statistically significant differences between the preoperative and postoperative scores obtained in the cognitive assessment.Single or two VF inductions and the brief arrest of cerebral circulation during ICD implantation are not associated with permanent neurological injury. However, further studies are needed to confirm this finding. (Int Heart J 2008; 49: 553-563)

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mentioning

confidence: 99%

<b>Defibrillation Testing and Early Neurologic Outcome</b>

Karaoğuz¹,

Altln²,

Atbaşoğlu

et al. 2008

Int. Heart J.

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Clinical Usefulness of Electrophysiologic Study (EPS)-Guided Risk Stratification for Life-Threatening Arrhythmia in Patients With Heart Failure

Abstract: SUMMARYBackground: Ventricular tachyarrhythmia is one of the most important factors deter-

Cited by 1 publication

References 29 publications

<b>Defibrillation Testing and Early Neurologic Outcome</b>

<b>Defibrillation Testing and Early Neurologic Outcome</b>

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