&lt;b&gt;Defibrillation Testing and Early Neurologic Outcome&lt;/b&gt;

Karaoğuz, Remzi; Altln, Timuein; Atbaşoğlu, E. Cem; Işıkay, Canan Togay; Güraslan, Bahar; Akyürek, Ömer; Beton, Osman; Vurgun, Kutay; Yüceman, Nezih; Soylu, Kazım; Güldal, Muharrem

doi:10.1536/ihj.49.553

Cited by 13 publications

(14 citation statements)

References 24 publications

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“…However, the clinical relevance of this transient finding is unclear because DT does not appear to cause cognitive dysfunction 24-48 hours following ICD implantation [200,201]. Although an increase in biochemical markers of myocardial injury can be observed during ICD implantation or after spontaneous clinical shocks, true intraoperative myocardial infarction (MI) is rare, even when extensive DT is performed [202][203][204][205].…”

Section: Iia B-nrmentioning

confidence: 99%

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

et al. 2016

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Section: Iia B-nrmentioning

confidence: 99%

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

et al. 2016

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“…[8][9][10][11] Induction of ventricular fibrillation (VF) during DFT can cause hemodynamic compromise, clinical deterioration, and life-threatening cerebrovascular accidents. [12][13][14][15] Thus, we conducted a retrospective study to assess the effect of DFT testing on long-term outcomes in patients with an ICD or cardiac resynchronization therapy defibrillator (CRT-D).…”

Section: Mplantable Cardioverter-defibrillators (Icds) Have Beenmentioning

confidence: 99%

Assessment of Efficacy and Necessity of Routine Defibrillation Threshold Testing in Patients Undergoing Implantable Cardioverter-Defibrillator (ICD) Implantation

et al. 2015

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SummaryDefibrillation threshold (DFT) testing is performed routinely in patients undergoing implantable cardioverter-defibrillator (ICD) implantation to verify the ability of the ICD to terminate ventricular fibrillation (VF). However, neither the efficacy nor the safety of DFT testing has been proven; thus, the necessity of such testing is controversial. We conducted a retrospective study of the efficacy of DFT testing, particularly with respect to long-term outcomes of ICD implantation.The study included 150 patients (125 men, 25 women, aged 59.0 ± 17.6 years) who underwent ICD or cardiac resynchronization therapy defibrillator implantation, with (n = 73) or without (n = 77) intraoperative DFT testing, between June 1996 and September 2007. VF was induced by delivery of a T-wave shock, and a 20-25-J shock was then delivered. If the 20-25-J shock failed to terminate VF, 30 J was delivered. We assessed whether undersensed VF events occurred during DFT testing and/or during patient follow-up and checked for any association between undersensing and delayed shock delivery. During DFT testing, fine VF was sensed, and shocks were delivered in a timely manner. Nevertheless, 2 patients in the DFT testing group died from VF within 3 years after device implantation.DFT testing, in comparison to non-DFT testing, appeared to have no influence on the long-term outcomes of our patients, suggesting that DFT testing at the time of ICD implantation is limited. (Int Heart J 2015; 56: 618-621) Key words: Ventricular arrhythmia, Mortality I mplantable cardioverter-defibrillators (ICDs) have been shown to reduce mortality resulting from both ischemic 1,2) and non-ischemic cardiomyopathies 2) and to terminate potentially fatal ventricular arrhythmias.3,4) Current indications for an ICD include not only a near-fatal arrhythmic event 5) and ischemic cardiomyopathy but also severe nonischemic cardiomyopathy with a low left ventricular ejection fraction (LVEF).Defibrillation threshold (DFT) testing during ICD implantation has been considered necessary for appropriate shock delivery, 6) and a DFT safety margin of 10 J is the standard recommendation.6,7) However, neither the efficacy nor benefit of DFT testing has been proven. [8][9][10][11] Induction of ventricular fibrillation (VF) during DFT can cause hemodynamic compromise, clinical deterioration, and life-threatening cerebrovascular accidents.12-15) Thus, we conducted a retrospective study to assess the effect of DFT testing on long-term outcomes in patients with an ICD or cardiac resynchronization therapy defibrillator (CRT-D). MethodsStudy patients: The study included 150 patients (125 men, 25 women) who received an ICD (n = 85) or CRT-D (n = 65) at our hospital between June 1996 and September 2007. Hospital records were obtained, from which we extracted the patient clinical characteristics, follow-up times, ICD intracardiac recordings, and clinical outcomes. The ICDs and CRT-Ds were implanted in a standard transvenous manner. We divided the patients into 2 groups, those in whom DFT...

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“…[11][12][13] Murkin et al 11 assessed 14 elective ICD patients in whom 12Ϯ6 episodes of VF were intraoperatively induced. At postoperative follow-up (5 days), 10 of 14 patients met the criteria for a significant 20% deficit in cognitive function from baseline, in particular, short-term memory and attention.…”

Section: Editorial See Page 118 Clinical Perspective On P 177mentioning

confidence: 99%

“…At postoperative follow-up (5 days), 10 of 14 patients met the criteria for a significant 20% deficit in cognitive function from baseline, in particular, short-term memory and attention. More recently, Karaoguz et al 13 assessed 16 ICD patients with 6 standardized cognitive function tests and NSE levels. Tests were administered 24 to 48 hours before implantation, and NSE levels were tested at 2, 24, and 48 hours after surgery.…”

Section: Editorial See Page 118 Clinical Perspective On P 177mentioning

confidence: 99%

A Prospective 1-Year Study of Changes in Neuropsychological Functioning After Implantable Cardioverter-Defibrillator Surgery

Hallas

Burke²,

White³

et al. 2010

Circ: Arrhythmia and Electrophysiology

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Background-The testing of the implantable cardioverter-defibrillator (ICD), through the induction of repeated episodes of ventricular fibrillation, has been associated with disturbances in cerebral activity and increased levels of cytoplasmic enzymes. However, the neuropsychological outcomes of cerebral changes and their quality-of-life implications are unknown. Methods and Results-Fifty-two ICD recipients completed standardized validated neuropsychological tests 1 to 3 days before ICD surgery and then 6 weeks, 6 months, and 12 months after surgery. They also completed psychometric tests measuring anxiety, depression, and quality of life. Between 31% and 39% of patients showed a significant neuropsychological impairment from their baseline function 6 weeks, 6 months, and 12 months after surgery. Ten percent of patients had late-onset deficits at 12 months only. Frequent areas of impairment were auditory and visual memory and attention. Neuropsychological impairment was not related to mood or quality of life at follow-up, although anxiety and depression predicted reduced quality of life. Conclusions-ICD implantation is associated with neuropsychological impairment that dissipates for the majority of recipients after 12 months. Short-term memory function and attention are particularly vulnerable to changes in oxygen during ICD testing. Although anxiety and depression are prevalent, there is little evidence for the direct impact of mood on cognition, and deficits appear not to be associated with reduced quality of life. These results provide evidence for longitudinal outcomes of ICD surgery and have implications for patient rehabilitation and adjustment. (Circ Arrhythm Electrophysiol. 2010;3:170-177.)

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

Cited by 13 publications

References 24 publications

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

Assessment of Efficacy and Necessity of Routine Defibrillation Threshold Testing in Patients Undergoing Implantable Cardioverter-Defibrillator (ICD) Implantation

A Prospective 1-Year Study of Changes in Neuropsychological Functioning After Implantable Cardioverter-Defibrillator Surgery

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