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Journal of the American College of Cardiology

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Clinical Articles, News & Views

Defibrillation testing irrelevant during ICD procedure?

Defibrillation testing (DT) during implantable cardioverter-defibrillator (ICD) implantation is of limited clinical relevance, and should be omitted from the procedure, according to a study published recently in the Journal of the American College of Cardiology.1

The SAFE-ICD (Safety of Two Strategies of ICD Management at Implantation) study evaluated the outcome of two strategies: performing defibrillation testing (DT+) versus not performing defibrillation testing (DT-) during de novo ICD implants. No deviation from the centers’ current practice was introduced.

In all, 2,120 consecutive patients (836 DT+ and 1,284 DT-) age ≥18 years were enrolled at 41 Italian centers from April 2008 to May 2009 and followed up for 24 months until June 2011. The primary endpoint was a composite of severe complications at ICD implant and sudden cardiac death or resuscitation at two years.

The primary endpoint occurred in 34 patients: 12 intraoperative complications (8 in DT+ group; 4 in DT- group) and 22 during follow-up (10 in DT+ group; 12 in DT- group). Overall, the estimated yearly incidence (95% confidence interval) was DT+ 1.15% (0.73 to 1.83) and DT- 0.68% (0.42 to 1.12). The difference between the 2 groups was negligible: 0.47% per year (–0.15 to 1.10). Mortality from any cause was similar at 2 years.

References

1. Michele Brignole, MD,* Eraldo Occhetta, MD,† Maria Grazia Bongiorni, et al. Clinical Evaluation of Defibrillation Testing in an Unselected Population of 2,120 Consecutive Patients Undergoing First Implantable Cardioverter-Defibrillator Implant.  JACC 2012. http://dx.doi.org/10.1016/j.jacc.2012.05.014

Published on: August 24, 2012

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ENDORSED BY

  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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