What is the clinical evidence from this study?

Study design: Cohort. Population: Patients receiving transvenous implantable cardioverter-defibrillators (ICDs) (n=835). Intervention: No defibrillation testing vs. Defibrillation threshold (DFT) testing or safety margin testing. Primary outcome: Overall mortality (HR 2.031, 95% CI 1.253-3.290, p=0.004).

October 10, 2005Journal of Cardiovascular ElectrophysiologyOpen Access

Intraoperative Testing of the Implantable Cardioverter‐Defibrillator: How Much Is Enough?

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Key result

Lack of intraoperative ICD testing was an independent predictor of overall mortality (HR 2.031; 95% CI 1.253-3.290; P=0.004) compared to performing defibrillation or safety margin testing.

Why the study?

Does intraoperative defibrillation testing improve survival and ICD therapy success in patients receiving transvenous ICDs?

Population

835 patients who received transvenous implantable cardioverter-defibrillators between January 1996 and…

Comparison

Intraoperative defibrillation threshold testing… vs No intraoperative defibrillation testing during…

Design

Cohort

Authors

LPLuís A. PiresBeth Israel Deaconess Medical Center KJKatrina M. JohnsonSt. John Hospital & Medical Center

Discussion

Member takes

Overview

Omitting intraoperative ICD testing was associated with higher mortality; leaves open whether routine testing improves survival and requires prospective confirmation.

Study Design

Type

Cohort (n=835)

Structured PICO

Does intraoperative defibrillation testing improve survival and ICD therapy success in patients receiving transvenous ICDs?

Population

835 patients (mean age 65, 23% female) who received transvenous implantable cardioverter-defibrillators between 1996 and 2003.

Exposure

Intraoperative defibrillation threshold (DFT) testing or limited defibrillation safety margin testing during ICD implantation.

Comparator

No intraoperative defibrillation testing during ICD implantation.

Outcome

Success of ICD therapies against spontaneous VT/VF events, sudden-death-free survival, and overall long-term survival.hard clinical

Main Result

Hazard Ratio: 2.031 (95% CI 1.253–3.29)

p-value: p=0.004

Omitting intraoperative defibrillation testing during ICD implantation is associated with higher overall mortality, supporting the continued use of at least safety margin testing.

Limitations

Retrospective analysis
Absence of prospective mortality data
Groups had important clinical differences

Cite This Study

Pires et al. (2005) conducted a cohort in Patients receiving transvenous implantable cardioverter-defibrillators (ICDs) (n=835). No defibrillation testing vs. Defibrillation threshold (DFT) testing or safety margin testing was evaluated on Overall mortality (HR 2.031, 95% CI 1.253-3.290, p=0.004). Lack of intraoperative ICD testing was an independent predictor of overall mortality (HR 2.031; 95% CI 1.253-3.290; P=0.004) compared to performing defibrillation or safety margin testing.

synapsesocial.com/papers/6a6c314d2ef98b0efacb82fe https://doi.org/10.1111/j.1540-8167.2005.00294.x

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October 10, 2005Journal of Cardiovascular ElectrophysiologyOpen Access

Intraoperative Testing of the Implantable Cardioverter‐Defibrillator: How Much Is Enough?

View Full Paper

Ask AI

Bookmark

Key result

Lack of intraoperative ICD testing was an independent predictor of overall mortality (HR 2.031; 95% CI 1.253-3.290; P=0.004) compared to performing defibrillation or safety margin testing.

Why the study?

Does intraoperative defibrillation testing improve survival and ICD therapy success in patients receiving transvenous ICDs?

Population

835 patients who received transvenous implantable cardioverter-defibrillators between January 1996 and…

Comparison

Intraoperative defibrillation threshold testing… vs No intraoperative defibrillation testing during…

Design

Cohort

Authors

LPLuís A. PiresBeth Israel Deaconess Medical Center KJKatrina M. JohnsonSt. John Hospital & Medical Center

Discussion

Member takes

Overview

Omitting intraoperative ICD testing was associated with higher mortality; leaves open whether routine testing improves survival and requires prospective confirmation.

Study Design

Type

Cohort (n=835)

Structured PICO

Does intraoperative defibrillation testing improve survival and ICD therapy success in patients receiving transvenous ICDs?

Population

835 patients (mean age 65, 23% female) who received transvenous implantable cardioverter-defibrillators between 1996 and 2003.

Exposure

Intraoperative defibrillation threshold (DFT) testing or limited defibrillation safety margin testing during ICD implantation.

Comparator

No intraoperative defibrillation testing during ICD implantation.

Outcome

Success of ICD therapies against spontaneous VT/VF events, sudden-death-free survival, and overall long-term survival.hard clinical

Main Result

Hazard Ratio: 2.031 (95% CI 1.253–3.29)

p-value: p=0.004

Omitting intraoperative defibrillation testing during ICD implantation is associated with higher overall mortality, supporting the continued use of at least safety margin testing.

Limitations

Retrospective analysis
Absence of prospective mortality data
Groups had important clinical differences

Cite This Study

synapsesocial.com/papers/6a6c314d2ef98b0efacb82fe https://doi.org/10.1111/j.1540-8167.2005.00294.x

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